Single Time Management Diseases in Pediatric Traumatology
Condition: Fractures, Bone
MeSH terms: Fractures, Bone
Study type: Observational [Patient Registry]

Summary: 
      A recent internal study evaluating the relevance of the visit to traumatology consultation in
      our establishment highlight that 49.3% of consultations were not relevant passages. The
      project consists of individualizing 5 to 6 pathologies and to create care sheets and patient
      sheets to be given to the care teams and patients when the pathology lends itself to it. The
      aim is to reduce the irrelevant passage rate during these consultations, which is the source
      of absence from iterative work for parents, collateral expenses (toll, parking), absence from
      school for the children, unjustified expenses and X-ray examination unnecessary most often.
    

Detailed description: 
      The Pediatric Orthopedics and Traumatology department proposes a reform of the care in
      Traumatology of the children in order to improve and homogenize the care for a better
      relevance of these.

      A recent internal study (June 2018) evaluating the relevance of the visit to traumatology
      consultation in our establishment to highlight that 49.3% of consultations were not relevant
      passages (Benign diseases of sprained ankle type, muscular contusion or simple bone
      removals). Indeed, these specialist consultations are currently filled by pathologies of
      simple treatment that do not require medical follow-up (neither clinical nor radiological
      follow-up).

      The project consists of individualizing 5 to 6 pathologies found in consultation recurrently
      which the scientific literature has established that their follow-up is not justified, and to
      create care sheets and patient sheets to be given to the care teams and patients when the
      pathology lends itself to it. These cards will include all the management of the pathology of
      the definition itself, including the treatment and expected outcomes.

      The aim is to reduce the irrelevant passage rate during these consultations, which is the
      source of absence from iterative work for parents, collateral expenses (toll, parking),
      absence from school for the children, unjustified expenses and X-ray examination unnecessary
      most often.

      The expected benefit is parental and child satisfaction, a time saving for the practitioner
      that he can reinvest in consultations for patients who are in fact a specialist opinion and a
      relative budget saving for the establishment.

      The method of study of the decline of irrelevant consultations will be made by a systematic
      review of each reason for consultation over a period of 3 months after implementation of the
      cards and study of the percentage of irrelevant consultation over the same period. The
      objective pursued is a drop in attendance of at least 25% of consultations deemed irrelevant
      in Traumatology, associated with a satisfaction rate of parents greater than 90%.
    

Intervention name(s): minor trauma
Intervention type(s): Other
Intervention description(s): following the management of the patient's fracture in the emergency department, the patients / parents are recalled 2 months (J60) after the visit to the emergency room, and are interviewed by following the pre-established interrogation form, which checks the good agreement of the patient. treatment performed with the given sheet and recommendations, and assesses the satisfaction.
Other intervention name(s): medical recommendation sheet
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Child from 1 to 18 years old suffering an isolated minor trauma presenting at the Lenval
        Foundation emergency services.
      
Keywords: Pediatric, traumatology, hemarthrosis, ankle, knee,; buckle fracture, clavicle, sprains