Audit of Fracture Clinic Services: Compliance with BOAST (British Orthopaedic Association Standards for Trauma and Orthopaedics) Guidelines

Background: The British Orthopedic Association Standards for Trauma (BOAST) provide guidelines for optimal fracture clinic management. However, compliance with these standards varies across healthcare institutions. This study evaluates the adherence of a fracture clinic to BOAST guidelines, focusing on imaging efficiency, patient satisfaction, and appointment scheduling. Methods: A prospective audit was conducted over four weeks (July 1^st - 30th, 2024) at Queens Hospital Romford, reviewing 50 consecutive patients. Data were collected using structured questionnaires covering demographics, treatment timelines, imaging delays, frailty service referrals, and patient-reported satisfaction. Statistical analysis included Chi-square tests and Mann-Whitney U tests to assess associations between delays and patient satisfaction. Results: Among the 50 patients, 30% experienced imaging delays exceeding 10 days (about 1 and a half weeks), and 25% faced follow-up delays beyond BOAST recommendations. A strong negative correlation (-0.658, p < 0.05) was observed between imaging delay and patient satisfaction. Patients with severe fractures reported a 0% satisfaction rate, underscoring the need for specialized care prioritization. Conclusion: The audit highlights significant inefficiencies in fracture clinic operations, particularly in imaging and appointment scheduling delays, impacting patient satisfaction. Implementing fast-track imaging protocols, enhanced scheduling, and optimized multidisciplinary referrals is recommended to improve BOAST guideline compliance and patient outcomes. A re-audit is necessary to assess the impact of these interventions.