Combined ortho-plastic team provides impressive approach to management of military patients
Nominated category: Team of the Year
The combined Ortho-Plastic Team at the University Hospital Birmingham NHS Foundation Trust, which consists of NHS and MOD personnel, provides an impressively coordinated approach to the management of military patients. The planning for incoming casualties begins well before they arrive at the hospital and often results in casualties being taken straight to the operating theatre on arrival to be dealt with by several consultant-led teams concurrently.
As well as Orthopaedics and Plastic Surgery, the core team includes microbiology, pain management and rehabilitation specialists. From the outset the focus is on delivering a multi-disciplinary, multi-specialty care package to each and every military patient. The weekly military ward round, involving the entire team, clearly addresses the need for battle casualties to have clear, progressive care plans aimed at an end-state, which, for the most complex, is admission to high intensity rehabilitation at the Defence Medical Rehabilitation Centre.
Clinically the most difficult challenge and one which has required the most innovative solutions has been the management of wound contamination. Orthopaedic fixation and soft tissue reconstruction must, in these circumstances, be planned in careful consultation with the microbiologists. Fixation and reconstruction must also take into account the need to begin rehabilitation early in order to achieve the best functional outcome for the patient. The unique needs of the military community, now met through an extensive patient support services team, has allowed the clinicians to focus on developing these innovative solutions.
Significant trauma in a young population requires a large and dedicated multi-disciplinary and multi-specialty team with a clear focus on functional recovery and the ability to make rehabilitation decisions very early in the pathway. Cross-speciality working provides an environment in which the needs of the patient come first and changes in practice can be implemented quickly.