1. A multifaceted strategy for implementation of the Ottawa ankle rules in two emergency departments
- Author
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Taryn Bessen, Geoffrey Hughes, Sepehr Shakib, Robyn Clark, Bessen, Taryn, Clark, Robyn A, SHAKIB, SEPEHR, and Hughes, Geoffrey
- Subjects
Program evaluation ,medicine.medical_specialty ,Radiography ,MEDLINE ,Injury ,Trauma ,medicine ,injury assessment ,Clinical Diagnostic Tests ,General Environmental Science ,Practice ,business.industry ,Medical record ,General Engineering ,ankle injury ,General Medicine ,Emergency department ,Community hospital ,medicine.anatomical_structure ,Radiology (Diagnostics) ,fracture ,Emergency medicine ,Physical therapy ,General Earth and Planetary Sciences ,Ankle ,Radiology ,business ,community hospital ,radiography ,teaching hospital ,Ottawa ankle rules ,patient selection - Abstract
Problem Despite widespread acceptance of the Ottawa ankle rules for assessment of acute ankle injuries, their application varies considerably. Design Before and after study. Background and setting Emergency departments of a tertiary teaching hospital and a community hospital in Australia. Key measures for improvement Documentation of the Ottawa ankle rules, proportion of patients referred for radiography, proportion of radiographs showing a fracture. Strategies for change Education, a problem specific radiography request form, reminders, audit and feedback, and using radiographers as “gatekeepers.” Effects of change Documentation of the Ottawa ankle rules improved from 57.5% to 94.7% at the tertiary hospital, and 51.6% to 80.8% at the community hospital (P
- Published
- 2009