Every year almost 4000 older adults find themselves in emergency rooms with a fractured hip. These hip fractures are increasing by about 2% every year because of a large cohort of aging baby boomers.
The Hip Fracture Redesign Project, one of the Quality and Innovation Initiatives sponsored by SSC, is implementing processes to provide optimal hip fracture care.
Currently, about 50% of hip fracture patients lose at least one level of mobility or independence. In hospital mortality rates have been as high as 30%, and the average length of stay is more than 17 days.
Initiatives from the UK and Sweden have identified simple measures that affect outcomes, such as early access to operative care, involvement of ortho-geriatricians/internists, use of care paths and multi-disciplinary teams, all of which have decrease complications, deaths and length of hospital stay. In the UK, these interventions have led to an estimated savings of 25 million pounds each year.
The Hip Fracture Redesign Project is a coordinated, evidenced-based initiative that includes developing hip fracture registries, performance measurements, and implementing best practices; including Enhanced Recovery After Surgery (ERAS) processes. The ERAS processes ensures a patient goes into surgery in an optimal state by providing surgery within 48 hours of a fracture, carb loading, increased hydration, increased communication within the multi-disciplinary team, and defined care paths. The project includes collecting important post-discharge data from patients, particularly about their mobility and morbidity after surgery.
The results are more patients receiving surgery within 48 hours, improved recovery with fewer complications, less days in bed, more effective rehab and a quicker return to the community.
The Hip Fracture Redesign Project began at four Lower Mainland hospitals, was expanded to eight sites and is now a provincial program encompassing all 28 BC hospitals providing hip fracture care. View video story. If you’d like to know more, please send us an email: sscbc@doctorsofbc.ca
