Cost-effectiveness of a nurse-led ORIF ankle care programme

In response to current outdated models of outpatient fracture care, a nurse-led ankle care protocol was implemented by Glasgow Royal Infirmary’s (GRI) fracture clinic. Its aim was to standardise post- surgery care for Open Reduction Internal Fixation (ORIF) ankle fractures, while maintaining patient reported outcomes. The demand for evaluation across healthcare in the UK is exponentially increasing and although the protocol has been widely accepted throughout the clinic, no evidence existed to confirm its cost-effectiveness. This study fills that gap in knowledge through a thorough cost-evaluation using Discrete Event Simulation (DES), a widely recognised and powerful modelling tool within healthcare evaluation. It was found that the difference between the total number of appointments attended patients between the two groups was not significant (p>0.05). However, results of the cost-modelling clearly show that a 28.12% saving can be achieved when comparing total staffing costs and X-ray costs between the two groups.