Best Practice in the management of

Whiplash Associated Disorders

Dr Saravana KumarDr Saravana Kumar

NHMRC NICS TRACsa MAC FellowNHMRC NICS TRACsa MAC Fellow

Acknowledgements

• This Fellowship is sponsored by– National Health and Medical Research

Council – National Institute of Clinical Studies

– Motor Accident Commission and TRACsa

Aim of the presentation• To take you on a journey through

– The theme of my research– My research process– The impact of my research

Health care in Australia

How Hazardous is Health Care? (Leape)How Hazardous is Health Care? (Leape)

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Driving

Bungee jumping

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Scheduled Airlines

European RailroadsNuclearPower

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

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

Quality of health care

• My research– Improving physiotherapy and chiropractic

management of whiplash

• What is whiplash?

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

Management of WAD• Physiotherapists and Chiropractors

– Crucial role, especially in the early stages– However

• conflicting evidence for many commonly used interventions & evidence-practice gap

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

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

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