Complete
Summary
National data shows an unwarranted variation in how people presenting to hospital with a suspected hip fracture are screened, assessed and managed. This places the patient at higher risk of poorer outcomes and readmission.
We partnered with five hospitals to develop and test a best practice pathway outlining time critical actions to promote high-quality patient care and support timely surgery.
Outcome
Older patients presenting with a common hip fracture had hip replacement surgery faster. At the five participating health services, we saw:
- decreased time to x-ray, and then to surgery, from a median of 26.28 hours to 19.98 hours
- more patients receiving a cognitive screen
- more patients having a ‘goals of care’ conversation and receiving an orthogeriatric model of care.
Targets
- Improved access to pain management, diagnostic imaging and cognitive screening for patients with suspected hip fractures
- Decrease in the median time to surgery for patients with hip fracture
Measures
- Percentage of patients with a hip fracture who have surgery within 24 hours of arrival.
- Percentage of patients with a suspected hip fracture who receive a pain assessment on presentation.
- Percentage of patients with a suspected hip fracture who receive analgesia within 30 minutes of arrival.
- Percentage of patients with a suspected hip fracture who have goals of care discussed pre-operatively.
- Percentage of patients with a suspected hip fracture who have a nerve block within 2 hours of arrival.
- Percentage of patients per week with a suspected hip fracture who have an X-ray within 60 minutes of arrival.
- Percentage of patients with a hip fracture who have a pre-operative cognitive screen using a validated tool.
- Percentage of patients per week with a suspected hip fracture who have an orthogeriatric or medical physician review pre-operatively.