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. 2022 Mar 20;14(3):e23338.
doi: 10.7759/cureus.23338. eCollection 2022 Mar.

Implementing the "Getting It Right First Time" (GIRFT) Report Recommendations: The Results of Introducing a Shoulder and Elbow Multidisciplinary Team

Hammad Parwaiz  1 , Robert Whitham  1 , Matthew Flintoftburt  1 , Andrew Tasker  1 , David Woods  1
Affiliations

Implementing the "Getting It Right First Time" (GIRFT) Report Recommendations: The Results of Introducing a Shoulder and Elbow Multidisciplinary Team

Hammad Parwaiz et al. Cureus. .

Abstract

Objective In this study, we aimed to analyse the impact of implementing the "Getting It Right First Time" (GIRFT) recommendations in our shoulder and elbow unit, which included the introduction of a shoulder and elbow multidisciplinary team (MDT) meeting for all patients being considered for surgery. Methods A retrospective patient case-note review was undertaken to assess the impact of replacing the pre-admission clinic with an MDT meeting. We analysed how many of the proposed management plans were changed as a result of this new MDT, as well as the associated cost savings. Results Of note, 118/148 patients who attended the MDT had a provisional operative plan; 24/118 (20%) had their plan changed to non-operative management, 13/118 (11%) had a change of operation, and 6/118 (5%) were recommended further investigations or tertiary referral. This reduced theatre time required by 47 hours, an estimated saving of over £51,000. Significantly, 20/24 patients who had their plan changed from operative to non-operative still had not had an operation after a median follow-up of 39 months. Conclusion The introduction of a shoulder and elbow MDT for all patients being considered for an operation has improved decision-making, allowed optimisation of non-operative management, and helped prevent patients from having unnecessary operations. This has led to a better patient experience and a more efficient service delivery, which is associated with cost savings.

Keywords: elbow; getting it right first time; girft; mdt; shoulder.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. The flowchart showing the decision-making process for all 148 patients who went through the shoulder and elbow MDT meeting
MDT: multidisciplinary team
Figure 2
Figure 2. The flowchart showing the costs of implementing a preoperative assessment clinic (PAC) versus a multidisciplinary team (MDT) meeting
These calculations show that the administrative costs of implementing an MDT are slightly higher compared to a PAC
See this image and copyright information in PMC

References

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