Fiona Cowell1, Sharon Gillespie2, Graham Cheung3, Daniel Brown3. 1. Extended Scope Physiotherapist in Trauma Management, Therapies Department, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, England, UK. Electronic address: fiona.cowell@rlbuht.nhs.uk. 2. Clinical Physiotherapy Specialist Upper Limb, Therapies Department, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, England, UK. 3. Consultant Orthopaedic Surgeon, Department of Orthopedics, Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, England, UK.
Abstract
STUDY DESIGN: Implementation paper. INTRODUCTION: Complex regional pain syndrome (CRPS) is relatively a common condition in the distal radius fracture (DRF) population with the effects resulting in many sufferers experiencing persistent pain and impairment 2 to 6 years after onset. Prevention is desirable as there is no known proven cure. PURPOSE OF THE STUDY: This study demonstrates how knowledge about CRPS and its prevention generated through iterative studies can be translated into practice in the workplace and how an interdisciplinary community of practice with therapists at the core can effect change. METHODS: A series of practice changes were introduced including a patient information leaflet, a local gold standard for care of DRF, education for staff regarding risk factors and early warning signs of CRPS, and simple patient and staff visual aids. RESULTS: The incidence of CRPS was reduced from 25% to 1% in the DRF population at the study site, and collaborative care pathways were ingrained onto the working culture. DISCUSSION: The process of learning together fostered the development of an interdisciplinary team with therapists acting as CRPS champions. Interdisciplinary team reflective practice facilitated simple but effective interventions, which reduced the incidence of CRPS in DRF population locally. It is not yet known whether this is transferable. CONCLUSIONS: Simple interventions can have a significant impact on the incidence of CRPS in a community of practice where a culture of team reflection and shared learning occurs.
STUDY DESIGN: Implementation paper. INTRODUCTION: Complex regional pain syndrome (CRPS) is relatively a common condition in the distal radius fracture (DRF) population with the effects resulting in many sufferers experiencing persistent pain and impairment 2 to 6 years after onset. Prevention is desirable as there is no known proven cure. PURPOSE OF THE STUDY: This study demonstrates how knowledge about CRPS and its prevention generated through iterative studies can be translated into practice in the workplace and how an interdisciplinary community of practice with therapists at the core can effect change. METHODS: A series of practice changes were introduced including a patient information leaflet, a local gold standard for care of DRF, education for staff regarding risk factors and early warning signs of CRPS, and simple patient and staff visual aids. RESULTS: The incidence of CRPS was reduced from 25% to 1% in the DRF population at the study site, and collaborative care pathways were ingrained onto the working culture. DISCUSSION: The process of learning together fostered the development of an interdisciplinary team with therapists acting as CRPS champions. Interdisciplinary team reflective practice facilitated simple but effective interventions, which reduced the incidence of CRPS in DRF population locally. It is not yet known whether this is transferable. CONCLUSIONS: Simple interventions can have a significant impact on the incidence of CRPS in a community of practice where a culture of team reflection and shared learning occurs.
Authors: Emily Z Boersma; Henk Vd Meent; Frank P Klomp; JanPaul M Frölke; Maria W G Nijhuis-van der Sanden; Michael J R Edwards Journal: Hand (N Y) Date: 2020-01-09