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Orthopedics audit 2016

Orthopedics audit 2016

Orthopedics audit 2016

  1. 1. Census– 2016 (01/01/16 ---- 31/12/16) JPNATC,AIIMS
  2. 2. EMERGENCY SERVICES
  3. 3. ED - Ortho Consultations 3 TOTAL PATIENTS IN E/D ORTHO CONSULT RED AREA YELLOW AREA GREEN AREA 2015 67044 25337 3624 11612 49677 2016 69551 26376 3929 15677 46998 0 10000 20000 30000 40000 50000 60000 70000 80000 Patients 38%
  4. 4. Emergency Department 0 5000 10000 15000 20000 25000 30000 ORTHO CONSULT DISCHARGES TRANSFER OUT 2014 24970 23645 1325 2015 25337 24323 1014 2016 26376 24878 1498 2014 2015 2016
  5. 5. Admissions-2013-16 0 20 40 60 80 100 120 140 160 180 2013 (N=1546) 2014(N= 1555) 2015(N=1418) 2016 (N=1417) 2016 118/month 27/week
  6. 6. Admission/Discharges/Death 2013 2014 2015 2016 ADMISSIONS 1546 1555 1418 1417 DISCHARGES 1564 1543 1363 1349 DEATH 18 12 8 7 0 200 400 600 800 1000 1200 1400 1600 1800 ADMISSIONS DISCHARGES DEATH
  7. 7. Bed Occupancy - 2016 • Total bed occupancy rate: 95% (Days of Care/Beds*days X100) • Open fractures: mean 21 days • Spine: mean 14 days • Pelvis & Acetabulum : mean 9 days • Peri articular fractures: mean 6 days • Diaphyseal fractures: mean 3 days • Upper limb fractures: mean 3 days
  8. 8. Critical Care Admissions-2016
  9. 9. Critical Care Admissions-2016 MULTIPLE LONG BONE # WITH CHEST/ABD TRAUMA PELVIS & CHEST/ABD TRAUMA SPINE GERIATRIC COMPLICATIONS 2013 (N=56) 21 4 14 17 2014 (N=40) 21 8 4 7 2015 (N=45) 18 4 15 8 2016 (N=43) 19 5 13 6 21 4 14 17 21 8 4 7 18 4 15 8 19 5 13 6 0 5 10 15 20 25
  10. 10. Critical Care Admissions-2016 DEATH =6(14%) SHIFTED TO WARD=37(86%) ORTHO ADMISSIONS=43
  11. 11. Follow-up OPD Census- 2016 ORTHOPEDICS, 20451, 50% SURG + NSx, 20143, 50% TOTAL ORTHO OPD REGISTRATIONS 2016 (N=20451)
  12. 12. Follow-up OPD Census 2014-16 0 5000 10000 15000 20000 25000 ORTHO GEN SURG NEURO 2014 18372 8074 6236 2015 19640 9703 7206 2016 20451 11145 8998 2014 2015 2016
  13. 13. Opd…timings..? 9 am –registration? 11 am-patient rush 2 pm-waiting patients Increase opd timings Opd rooms
  14. 14. OPD Registrations:2013-16 15 NEW REGISTRATIONS OLD REGISTRATIONS 2013 (N=18475) 8419 10056 2014 (N=18711) 8372 10339 2015 (N=19640) 8623 11017 2016 (N=20451) 8886 11565 0 2000 4000 6000 8000 10000 12000 14000 2013 (N=18475) 2014 (N=18711) 2015 (N=19640) 2016 (N=20451)
  15. 15. OPD Procedures(minor) 16 2013 (N=12328) 2014 (N=12751) 2015 (N =12849) 2016 (N=11123) DRESSING 2929 3245 3308 2862 SUTURE REMOVAL 2147 1551 1602 1496 EX FIX REMOVAL 72 48 63 69 K WIRE REMOVAL 104 110 130 127 DEBRIDEMENT 17 72 89 23 OTHERS 342 442 466 328 POP PROCEDURES 6717 7283 7380 6128
  16. 16. Surgeries Monthly Calendar : 2014-16
  17. 17. Operated Cases -2016 ROUTINE , 951, 54% EMERGENCY (inc LOCAL) 794, 46% N=1745 ROUTINE EMERGENCY
  18. 18. Routine/Emergency Cases-2014- 16 0 200 400 600 800 1000 1200 1400 2014(N=2075) 2015(N=1826) 2016 (N=1745) ROUTINE CASES 1265 1022 951 EMERGENCY CASES 810 804 794 1265 1022 951 810 804 794
  19. 19. Sex Distribution - 2016 MALES , 1367, 78% FEMALE, 378, 22% SEX DISTRIBUTION (N=1745)
  20. 20. Surgeries - over all review 2014(N=1891) 2014(N=184) AXIAL SKELETON APPENDICULAR SKELETON 2012(N=219) 2012 (N=1978) 2013(N=231) 2013(N=1895) 2015(N=1665) 2015(N=161) 2016(N=212) 2016(N=1533) 12% 88%
  21. 21. Spine
  22. 22. Spine Surgeries : 2015-16 CERVICAL DORSOLUMAR TOTAL 2015(N=83) 11 72 83 2016 (N=95) 12 83 95 0 10 20 30 40 50 60 70 80 90 100
  23. 23. Pelvi-acetabular Fractures
  24. 24. Pelvi-acetabular Fractures : 2015-16 0100 #REF! Emergency external fixation Combined approaches Percutaneous fixation Total hip replacements for post-traumatic arthritis 117 surgeries
  25. 25. Long Bone - Femur
  26. 26. Femur Surgeries : 2015-16 27 PROX FEMUR SHAFT FEMUR DISTAL FEMUR HRA/THR 2015 (N=416) 196 152 42 26 2016 (N=478) 214 166 55 44 196 152 42 26 214 166 55 44 0 50 100 150 200 250
  27. 27. Leg Bones
  28. 28. Leg And Foot : 2013-16 PROX TIBIA(I/A) BB LEG DISTAL TIBIA & ANKLE TALUS CALCANEUM 2013 (N=395) 88 112 142 13 40 2014 (N=335) 102 100 109 8 20 2015(N=362) 112 98 124 6 22 2016 (N=359) 105 104 92 9 15 0 20 40 60 80 100 120 140 160
  29. 29. Upper Limb Trauma
  30. 30. Upper Limb Trauma : 2014-16 31 PROX HUMERUS SHAFT HUMERUS DISTAL HUMERUS FOREARM DISTAL RADIUS 2014(N=374) 46 62 93 108 65 2015(N=320) 33 68 63 84 72 2016 (N=360) 52 48 89 97 74 46 62 93 108 65 33 68 63 84 72 52 48 89 97 74 0 20 40 60 80 100 120
  31. 31. Compound Fracture Procedures-2014 TO 16 32 DEBRIDEMENT & EX. FIX AMPUTATION DEBRIDEMENT & DEFINITIVE FIXATION 2014 (N=194) 147 42 5 2015 (N=108) 85 19 4 2016 (N=169) 143 9 17 147 42 5 85 19 4 143 9 17 0 20 40 60 80 100 120 140 160
  32. 32. Arthroscopy
  33. 33. Arthroscopy : 2012-16 KNEE SHOULDER ANKLE 2012 (N=45) 35 10 0 2013 (N=41) 37 4 1 2014 (N=33) 32 1 1 2015 (N=25) 22 3 0 2016 (N=37) 25 11 1 35 10 0 37 4 1 32 1 1 22 3 0 25 11 1 0 5 10 15 20 25 30 35 40
  34. 34. Other Procedures -2013 TO 16 0 20 40 60 80 100 120 140 2013 (N=254) 2014 (N=283) 2015 (N=155) 2016 (N=155)
  35. 35. Liaison Services FRAGILITY FRACTURE CLINIC Over 200 patients registered in 2016 Retrospective follow-up of over 1000 patients Research and project work SPINE TRAUMA CLINIC Every Monday morning Increasing number of spine trauma patients
  36. 36. Achievements… 37 HIGHEST NUMBER OF PELVI- ACETABULAR SURGERIES IN INDIA COMPLEX INTRA-ARTICULAR FRACTURES 35% OF TOTAL SURGERIES 17 INDEXED PUBLICATIONS IN 2016 FROM ORTHOPAEDICS TEAM AT JPNATC SUCCESSFULLY CONDUCTED REGIONAL AND NATIONAL CONFERENCES TEAM ORTHO
  37. 37. Challenges Ahead ….. GERIATRIC PATIENTS : SILENT EPIDEMIC ON THE RISE! -- Establishment of geriatric trauma ward -- Managing medical co-morbidities NEED TO INCREASE BED CAPACITY IN WARDS --Regretted patients (1498) DEDICATED 24 HOURS EMERGENCY ORTHO OT -- Routine(54%)/emergency(46%) TO INCREASE THE OPD TIMINGS/OPD ROOMS --51% of total OPD patients ORTHO REGISTRY -trained staff for the registry documentation
  • ClementMwamba

    Jun. 23, 2019

Orthopedics audit 2016

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