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.