Effect of house officer clerking on short-term outcomes in paediatric orthopaedic patients.

AIM: Children who are admitted with acute orthopaedic problems are often fit and healthy. The house officer (ie, intern) is required to carry out the formal clerking/admission of inpatients. However, they are often also busy with sick ward patients, which leads to delays in formal clerking of these children until after they have been to the operating theatre (OT). The aim of this study was to assess what information, if any, is missed in children who were seen by a house officer prior to going to OT, compared to those who were not.

METHODS: All patients admitted to the paediatric surgical ward, under the orthopaedics service care, between 1 September 2015 and 30 November 2015 were included in this study. Information on age, sex, medical background, details of the admission and post-operative complications were collected.

RESULTS: A total of 139 children were admitted during the study period. The median age was 7.4 years (range, 0.2-17.5) and a male:female ratio of 1.3:1. In this study, there was no statistically significant difference in patient characteristics, post-operative complications or length of hospital stay. However, patients clerked by house officers had better documentation of their regular medications and non-orthopaedic examination findings.

CONCLUSION: To the author's knowledge, this is the first study to examine the effect of house officer admission on paediatric orthopaedic patient outcomes. A suggested solution would be to encourage documentation of medication history and examination findings by the anaesthetic registrar, since all patients must be reviewed pre-operatively.