Getting it right first time (GIRFT): A closed loop study of hip arthroplasty documentation in a trauma and orthopaedic department.

INTRODUCTION

The objectives of this study conducted in the University Hospital of North Tees, UK were to: (i) Identify if the current hip arthroplasty documentation met good compliance with the Getting It Right First Time (GIRFT) hip arthroplasty guidance (ii) Improve current documentation with a transition from hand-written notes to an online typed personalised operative hip arthroplasty template (iii) Improve the quality of documentation and adherence to GIRFT guidance in hip arthroplasty.

METHODS

We led a team of 7 doctors to review University Hospital of North Tees compliance against 24 criteria laid out by GIRFT. After examining 20 operative records retrospectively at random from a spread of orthopaedic consultants in the department, it was shown that there was poor compliance against GIRFT guidelines. We proposed a pragmatic solution of incorporating a pre-populated hip arthroplasty online template adhering to GIRFT guidance into our local 'Trackcare' system. Following that, we closed the audit loop by prospectively reviewing 20 operative notes.

RESULTS

Our initial results showed that poor compliance ranging 0%-100% over the 24 criteria. The findings of the 24 criteria with the online hip arthroplasty template in place showed a significant improvement between 80 and 100% compliance over the 24 criteria.

CONCLUSION

The majority of the issues identified are modifiable risks factors which were amenable to some simple pragmatic solutions. A review of a single surgeon template has shown that it is simple to use, has excellent compliance (has pre-populated 24 criteria), takes 6-7 min to complete the operative notes, easily auditable and thus appears promising in minimising medico-legal claims for surgeons and the Trust.