Protocol-guided hip fracture management reduces length of hospital stay

To see if protocolised hip fracture care led to an improvement in patient management and more standardized treatment with the aim of reducing wait for surgery and postoperative length of stay.

Following the introduction and establishment of a care pathway a retrospective, observational audit was conducted with patient data and pathway compliance obtained from analysing medical notes and accessing electronic patients' records.

The audit analysed all patients who sustained a fractured hip admitted to University College London Hospital over 18-month period between August 2009 and February 2011.

In addition to demographic data, a comparison was made between those who were and were not managed with the care pathway. Investigation, preoperative management, time to surgery, length of stay and mortality were all evaluated.

Patients managed via the care pathway had significantly more investigations and preoperative interventions, had subsequently had a reduced length of hospital stay (a mean average of 13 compared to 17 days). There was no significant difference in time from admission to surgery, and 30-day mortality.

Using a care pathway to manage those patients sustaining fractured femur appears to make preoperative management more consistent. This, in turn, leads to a reduction in length of hospital stay.