May 152018

New Wait Time Benchmark for Hip Fracture Surgical Care

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Recent data from the Canadian Institute for Health Information (CIHI) indicates that Alberta is second across Canada in meeting the national evidence-based benchmark for getting hip fracture patients into surgery within 48 hours of arrival to a hospital.

In 2017, following closely behind Manitoba, 92% of Albertan patients received hip fracture repair surgery within 48 hours of admission to an inpatient hospital unit, up from 85% in 2013. Half of Albertan hip fracture patients were treated within 19 hours. Studies show patients who have surgery within 48 hours of hospital admission and who are up and moving soon after surgery have the best outcomes. Their risk of complications and mortality is also 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.

Alberta is also one of three provinces reporting emergency department data to CIHI. In 2017, 89% of Albertan hip fracture patients received hip fracture repair surgery within 48 hours of admission to the emergency department, up from 76% in 2013. As part of the provincial Alberta Health Services Bone and Joint Health Strategic Clinical Network (BJH SCN) Fragility and Stability program, the Alberta Bone and Joint Health Institute (ABJHI) helps to support provincial continuous quality improvement through measurement reporting each quarter to health care teams.

“Surgical teams across Alberta have worked very hard over the past few years to improve time to surgery,” said Kyle Lang, who leads the BJH SCN Fragility and Stability Acute Surgical Working Group along with Dr. Cinzia Gaudelli. “Our teams have not only met the 48-hour benchmark; they have bettered it, getting around half of hip fracture patients into surgery within 24 hours in the last year.”

Following these successes and upon recommendation from the BJH SCN Fragility and Stability Clinical Committee, the bar has been confidently raised to a new benchmark target: 36 hours. The prospect of good outcomes is even better for patients who have surgery within 36 hours.

ABJHI is helping to coordinate the team efforts to meet the new 36-hour target at hospitals across Alberta. “The Acute Surgical Working Group, along with the other Fragility and Stability groups, are committed to restoring quality of life to hip fracture patients—and in some cases even improving it. The program will continue to focus on improving care for people with poor bone health and providing the supports that they need,” said Amanda Pellecchia, ABJHI’s Quality Improvement Manager for the Fragility and Stability Program.

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