Timing Hip Fracture Repair
From restoring quality of life to saving a life, triaging emergency hip fracture surgery makes the difference.
Challenge
Studies indicated having surgery within 48 hours of hospital admission results in the best outcomes for people with a hip fracture. Their risk of complications and mortality is reduced. The patients regain more function, are discharged from the acute care hospital sooner, and are more likely to return to where they lived prior to their fractures. In 2012, only half of patients received surgery within 48 hours of admission to an emergency department.
Problems to Solve
Awareness towards consequences of surgical delays in hip fracture population
Resourcing limitations for implementing clinical pathway
Approach
Integration across the care continuum was crucial to success in improving waiting time for hip fracture surgery. Hip Fracture teams of frontline staff (EMS, emergency, pre-op, OR, post-op), physicians, and transition services were engaged. New decision supports for emergency department and hospital care helped guide provincial best practices, such as order sets and algorithms. We supported sites in sharing learnings and experiences, identifying barriers preventing following of the care pathway, and celebrating successes. We engaged with all operational levels from top leadership (e.g. availability of dedicated trauma surgeons) down to the front-line (e.g. anticoagulation best practices).
Tangible Outputs
- Variance assessments
- Key performance indicator flowcharts
- New reporting metrics
Decision Supports
Click below to access tools based on high-quality evidence for making informed health decisions.
Results
By 2017, 89% of patients received this life-saving operation within 48 hours of presentation at a hospital, with over 50% within 24 hours. In 2018, the benchmark was raised to 36 hours. Three years later, despite a global pandemic, over 70% of hip fracture surgeries meet the new 36-hour benchmark.
