Best Practice in the management of Whiplash Associated Disorders
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Transcript of Best Practice in the management of Whiplash Associated Disorders
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Best Practice in the management of
Whiplash Associated Disorders
Dr Saravana KumarDr Saravana Kumar
NHMRC NICS TRACsa MAC FellowNHMRC NICS TRACsa MAC Fellow
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Acknowledgements
• This Fellowship is sponsored by– National Health and Medical Research
Council – National Institute of Clinical Studies
– Motor Accident Commission and TRACsa
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Aim of the presentation• To take you on a journey through
– The theme of my research– My research process– The impact of my research
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Health care in Australia
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How Hazardous is Health Care? (Leape)How Hazardous is Health Care? (Leape)
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DANGEROUS REGULATED ULTRA-SAFE
(>1/1000) (<1/100K)Health Care
Driving
Bungee jumping
Mountain Climbing
Chemical Manufacturing
Chartered Flights
Scheduled Airlines
European RailroadsNuclearPower
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Health Care in AustraliaHealth Care in Australia• Challenges facing health care
– Increasingly ageing population– Increasing co-morbidities– Increasing pressures on health care
resources• Minimising wastage
– Increasing need for quality in health care• Patient being an active participant
– Chronic shortage of health professionals
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Drastic changes to health careDrastic changes to health care
• Quality in health care– Increasing need for accountability
• Quality in health care underpinned by safety, effectiveness, patient centeredness, timeliness, equity and efficiency
• Evidence Based Practice– Integrating research evidence with
clinical expertise and patient values
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Quality of health care
• My research– Improving physiotherapy and chiropractic
management of whiplash
• What is whiplash?
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Whiplash and its management
• Whiplash Associated Disorders (WAD) accounts for 42% of compulsory third party insurance claims
• 14-42% with whiplash develop long term complaints with 10% in constant severe pain
• Complexities in management of WAD– Structures involved– Patients expectations– Compensation system
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Management of WAD• Physiotherapists and Chiropractors
– Crucial role, especially in the early stages– However
• conflicting evidence for many commonly used interventions & evidence-practice gap
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Clinical guidelines for WAD• Development of a new clinical guideline
(TRACsa WAD guideline)• This project is about implementing this guideline
to address the evidence-practice gap
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Implementation of TRACsa guideline
• Evidence on successful implementation strategies for practitioners– Multi-dimensional strategies– Recognising barriers and enablers– Support and recognition– Intention-behaviour gap and stages/domains
of behaviour change
• Involvement of consumers– Active participant and act as drivers for
change
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Outcomes from this research• Unique and world first
– Physiotherapy and chiropractics together– Active involvement of consumers– Bridging gap between research evidence and
clinical practice• Implementation science
– Cutting edge research on understanding behaviour change
Insanity: doing the same thing over and over again and expecting different results.
– Albert Einstein