title: Does it matter whom you see? - a fracture clinic audit.
abstract: BACKGROUND
  A consultant-led service for trauma in the UK has become the accepted norm. Practice in fracture clinics may vary widely between consultants and has an impact on the number of patients seen and, therefore, the time devoted to each patient.
  
  
  METHODS
  A total of 945 patients attending our unit's fracture clinics were analysed over a 6-week period, representing one complete cycle of our trauma system.
  
  
  RESULTS
  The overall discharge rate was 38% but this differed significantly between consultants. Patients re-presenting for the same complaint were evenly distributed between those discharging aggressively and those re-reviewing regularly.
  
  
  CONCLUSIONS
  Re-reviewing patients has a significant impact on the number of patients seen in future clinics and, therefore, the time that can be devoted to each patient, individual consultant workload and teaching of junior staff. Since the re-presentation rate between those discharging aggressively and those re-reviewing more frequently was the same, discharge protocols are recommended for common trauma conditions to standardise the process. Specialist clinics are recommended for more complex trauma cases.
authors.affiliation: Department of Trauma and Orthopaedics, West Wales General Hospital, Carmarthen, UK. tomcosker@hotmail.com
authors.forename: T D A
authors.initials: TD
authors.lastname: Cosker
authors.forename: A
authors.initials: A
authors.lastname: Ghandour
authors.forename: T
authors.initials: T
authors.lastname: Naresh
authors.forename: K
authors.initials: K
authors.lastname: Visvakumar
authors.forename: S R
authors.initials: SR
authors.lastname: Johnson
mesh_terms: D000553:Ambulatory Care / Q000592:standards*; D003253:Consultants; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D008485:Medical Audit; D008505:Medical Staff, Hospital / Q000592:standards*; D010351:Patient Discharge / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011787:Quality of Health Care; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D014852:Wales