Orthopaedics Quality Audit

---
name: orthopaedics-quality-audit
description: |
  Audit the quality of orthopaedic surgeon work in an orthopaedic theatre and fracture clinic and drive measurable improvement.
  TRIGGERS - Use when a orthopaedic surgeon needs a quality audit for patients with bone, joint and muscle injuries or conditions in an orthopaedic theatre and fracture clinic.
category: Orthopaedics
license: MIT
version: 1.0
---
# Quality Audit — Orthopaedics

Audit the quality of orthopaedic surgeon work in an orthopaedic theatre and fracture clinic and drive measurable improvement. The deliverable is an audit report with scores, evidence and an improvement plan.
This skill is written for a orthopaedic surgeon working with patients with bone, joint and muscle injuries or conditions in an orthopaedic theatre and fracture clinic.

## When to use
- You are a orthopaedic surgeon preparing, delivering or reviewing this part of your work in an orthopaedic theatre and fracture clinic.
- You need a defensible, repeatable approach that produces an audit report with scores, evidence and an improvement plan.
- A colleague, auditor or client asks how this was done and what evidence supports it.

## Key Concepts
| Term | Meaning |
|------|---------|
| Fracture | a break in a bone |
| Arthroplasty | surgical replacement of a joint |
| Compartment syndrome | dangerous pressure build-up within a muscle compartment |

## Workflow
1. **Step 1** - Define the audit sample and criteria up front, anchored to surgical site infection rate and the standards for an orthopaedic theatre and fracture clinic
2. **Step 2** - Review a sample of operation notes and observe practice where permitted, scoring consistently
3. **Step 3** - Separate isolated errors from patterns — patterns point to system fixes, not individual blame
4. **Step 4** - Report findings with evidence, and agree improvement actions that address the root causes, including wrong-site surgery
5. **Step 5** - Re-audit after the agreed interval and publish the change in scores so improvement is visible

## Profession-Specific Components
| Component | Details for Orthopaedics |
|-----------|-------------------------------|
| Core documentation | operation notes; fracture assessments; implant records; physiotherapy referrals |
| Core tools & equipment | operating microscopes and drills; C-arm fluoroscopy; splints and casts; traction equipment |
| People involved | patients with bone, joint and muscle injuries or conditions; the orthopaedic surgeon; colleagues and other services in an orthopaedic theatre and fracture clinic |
| Primary record | operation notes — keep it current, dated and attributable |

## Output Format
**Context:** [Situation in an orthopaedic theatre and fracture clinic] | **Objective:** [What this must achieve] | **Audience:** [patients with bone, joint and muscle injuries or conditions and other stakeholders]

The finished output is an audit report with scores, evidence and an improvement plan, structured as:
1. Summary of position and evidence
2. Detail, following the workflow above
3. Decisions, actions, owners and dates
4. Review point and escalation route

### Action Plan
1. **Immediate:** Confirm scope, consent and the evidence available in operation notes.
2. **Short-term:** Complete the workflow steps and record outcomes against surgical site infection rate.
3. **Medium-term:** Review results, close actions, and update local procedures in an orthopaedic theatre and fracture clinic.

## Success Metrics
| Metric | Target | Method |
|--------|--------|--------|
| surgical site infection rate | Agree a local target and track the trend | Measured from operation notes and reviewed on a set cycle |
| fracture clinic waiting time | Agree a local target and track the trend | Measured from operation notes and reviewed on a set cycle |
| implant revision rate | Agree a local target and track the trend | Measured from operation notes and reviewed on a set cycle |
| mobility recovery scores | Agree a local target and track the trend | Measured from operation notes and reviewed on a set cycle |

## Guardrails & Quality Checks
- Never let this happen: wrong-site surgery.
- Never let this happen: compartment syndrome missed.
- Never let this happen: post-operative infection.
- Work only within the competence and authority of a orthopaedic surgeon; escalate or refer anything beyond it.
- Record facts and observations, not speculation, and keep records confidential to an orthopaedic theatre and fracture clinic's rules.
- Verify names, dates, figures and measurements twice before anything is issued or signed off.
- Use only real, verified information from the case in hand — never invent results, credentials or evidence.

## Example (illustrative)
A orthopaedic surgeon in an orthopaedic theatre and fracture clinic applies this workflow for patients with bone, joint and muscle injuries or conditions: they open
operation notes, work through the five steps using operating microscopes and drills, and close by recording
the outcome against surgical site infection rate and agreeing the next review date. (Illustrative example only —
replace with the real details of the case in hand.)