Improving adherence to appropriate use criteria for paediatric supracondylar humerus fractures: a three-cycle quality improvement project

A phased quality improvement initiative combining education, protocolisation, reinforcement training and audit feedback significantly improved adherence to evidence-based guidelines for paediatric SCHFs. Sustained educational interventions with regular case-based discussions and individualised feedback are essential for long-term practice change. Organisational factors, particularly lack of awareness and inconsistent application of guidelines, represent the primary modifiable barriers to adherence.