Effecting change using careplans: experience from two fractured neck of femur pathways

Baker, Kylie, Brierley, Stephen, Mitchell, Geoffrey and Roe, John (2012) Effecting change using careplans: experience from two fractured neck of femur pathways. Australian Health Review, 36 3: 308-312. doi:10.1071/AH11021

Author Baker, Kylie
Brierley, Stephen
Mitchell, Geoffrey
Roe, John
Title Effecting change using careplans: experience from two fractured neck of femur pathways
Journal name Australian Health Review   Check publisher's open access policy
ISSN 0156-5788
Publication date 2012-07-06
Sub-type Article (original research)
DOI 10.1071/AH11021
Volume 36
Issue 3
Start page 308
End page 312
Total pages 5
Place of publication Collingwood, VIC, Australia
Publisher C S I R O Publishing
Collection year 2013
Language eng
Formatted abstract
Objective. To use a qualitative track of the effects of two fractured neck of femur careplans (1 & 2) implemented at the Ipswich Emergency Department in 2002 and 2003 in order to comment on the reasons for comparative successes and failures as instruments for change in clinical practice. Careplan 1 was initiated by local clinicians in 2002, rescinded in 2003 to make way for the system wide careplan 2, then informally restituted in 2004 after careplan 2 was withdrawn. Careplan 2 did not articulate specific ED management plans.

Method. Biennial retrospective chart audits of two newly introduced evidence-based clinical practices over time was used to track changes from careplan 1. These were the use of regional anaesthesia by medical staff, and the compliance with indwelling urinary catheter insertion by nursing staff.

Elements of careplan 1 continued despite lack of promotion. There has been significant increase in nerve block (2.8% to 27%) and indwelling catheter insertion (26% to 75%) from 2000 to 2009. Formal use of careplan 1 has declined to 13–20% in 2009. Careplan 2 was withdrawn for review in 2004.

Careplans are one way to effect lasting changes in clinical behaviours which may persist beyond their implementation and promotion phases. For acceptance, corporate plans should incorporate local practices. For longevity, local plans should comply with the corporate vision of continuity of care, but local investment in the plan will facilitate uptake.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Discipline of General Practice Publications
Official 2013 Collection
School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 1 times in Thomson Reuters Web of Science Article | Citations
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Created: Fri, 20 Jul 2012, 13:30:52 EST by Shani Lamb on behalf of Discipline of General Practice