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

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