IITOS Safe Clinic Guidelines


Irish Institute of Trauma and Orthopaedic Surgery Safe Clinic Guidelines (2011)

With regard to the workload of fracture clinics, the perception is that it is difficult to regulate the number of new patients because of the nature of the work. Trauma activity however is largely predictable with winter and summer peaks. Fracture clinic work should, be so staffed and organised that:

All musculoskeletal injuries which require follow-up should be seen promptly in the fracture clinic.
Fracture clinics should be under the personal direction of a Consultant Orthopaedic surgeon. Patients may be seen by Extended Scope Practitioners working to a protocol, they must be deemed by the Consultant Orthopaedic surgeon to be of appropriate competence and seniority. The care and responsibility remains with the consultant orthopaedic surgeon.
Numbers at the clinic must be such that the Consultant can devote a reasonable amount of time to each patient. (BOA /IITOS)

The following figures for the time to be devoted to patients in outpatient clinics are considered reasonable, given that proper clinic and ancillary facilities are available:

The above applies to general orthopaedic and fracture clinics run by a consultant.

These times include the initial consultation and review following x-ray, discussions on informed consent, dictation of notes and necessary telephone calls, etc.

This time is recognised in the Consultant contract and should be built into the planned OPD session.

Specialist and teaching clinics may require an increase of up to 50% in time allowed per patient. Extended Scope Practitioners working in the clinic will also require additional time for advice.