AB119. 203. GDPR: improving our compliance with the Blue Book Standards?

Background: Compliance with Blue Book Standards (BBS) is essential for hip fracture patient care. Communication is integral to providing an efficient service. It was thought GDPR would impede healthcare provider communication. MedXNote is an encrypted GDPR compliant messaging service, which can be downloaded as a phone app. Many of the BBS are time-dependent; rapid, confidential communication is paramount. The authors aim to analyse the effect of a MedXNote Hip Fracture messaging group on our trauma unit’s BBS compliance.

Methods: Access to the MedXNote Hip Fracture Group was provided to all stakeholders in hip fracture care trainee and consultant emergency physicians and orthopaedic surgeons, as well as advanced nurse practitioners, bed managers, ward managers and theatre managers. BBS compliance for the period of April to July 2017 was compared with that of April to July 2018

Results: Two periods in 2017 and 2018 saw 33 and 39 hip fracture patients admitted respectively. Mean time to an orthopaedic ward in 2017 was 40 (SD +/−40.3) hours compared to 7.7 (SD +/−2.43) hours in 2018 (P=0.06, NS). No cases were admitted to an orthopaedic ward within 4 hours. Mean time to surgery was 65.0 (SD +/−30.2) hours in 2017 and 32.7 (SD +/−10.6) hours in 2018 (P=0.02). And 53% of patients had surgery within 48 hours of admission in 2017, compared to 81% in 2018 (P=0.14, NS).

Conclusions: Improving a trauma unit’s BBS compliance requires an efficient multidisciplinary approach. Timely communication between stakeholders can improve these time dependent measurements. MedXNote, a GDPR compliant social media messaging service, has helped to significantly reduce the time to surgery for hip fracture patients in our trauma unit. These promising results show these communication-enhancing efforts could lead to improvements nationwide.

Keywords: Blue Book; hip fractures; orthopaedics; trauma