Best Practice in the management of Whiplash Associated Disorders

1. Best Practice in the management of Whiplash Associated Disorders Dr Saravana Kumar NHMRC NICS TRACsa MAC Fellow

2. Acknowledgements • This Fellowship is sponsored by • National Health and Medical Research Council – National Institute of Clinical Studies • Motor Accident Commission and TRACsa

3. Aim of the presentation • To take you on a journey through • The theme of my research • My research process • The impact of my research

4. Health care in Australia

5. How Hazardous is Health Care? (Leape) DANGEROUS REGULATED ULTRA-SAFE (>1/1000) (<1/100K) Health Care 100,000 10,000 1,000 100 10 1 Driving Total lives lost per year Scheduled Airlines Mountain Climbing Chemical Manufacturing Chartered Flights European Railroads Nuclear Power Bungee jumping 1 10 100 1,000 10,000 100,000 1,000,000 10,000,000 Number of encounters for each fatality

6. Health 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

7. Drastic 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

9. Quality of health care • My research • Improving physiotherapy and chiropractic management of whiplash • What is whiplash?

10. 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

11. Management of WAD • Physiotherapists and Chiropractors • Crucial role, especially in the early stages • However • conflicting evidence for many commonly used interventions & evidence-practice gap

12. 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

13. 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

14. 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