VFC and Torus Fracture Management: A Closed 3 Loop Cycle Quality Improvement Project 

Description

In this presentation, Melissa Mahoney discusses a quality improvement audit conducted at Barnet Chase Farm Hospital, part of the Royal Free Hospital Trust. The focus of the audit is on managing Torus fractures, a common yet often mismanaged injury in children, which the team aimed to address due to the burden placed on fracture clinics. The audit seeks to reduce unnecessary X-rays and clinic visits, thereby saving time and costs.



Melissa explains the nature of a Torus fracture—an incomplete fracture of a long bone that typically only requires a simple splint and can often be managed without multiple follow-up visits. The initial audit cycle revealed that only 18% of these fractures were appropriately managed, leading to a high rate of unnecessary referrals. She outlines the cost implications of these mismanagements—from the initial visit to more expensive follow-ups—highlighting that a more efficient management approach could save considerable resources for the trust.



Over three audit cycles, the introduction of an electronic Virtual Fracture Clinic (e-VFC) form significantly improved the situation, helping to clarify management pathways for healthcare providers. By the third cycle, 81% of patients were treated appropriately, with no direct referrals from Emergency Department (ED) to the fracture clinic. Melissa concludes that this structured approach not only improves patient care but also substantially reduces costs, yielding potential savings of up to £28,000 annually.

DOI: 10.1302/3114-230093

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