Implementing the National Hip Fracture Database: An audit of care

Area of Science:

• Geriatric Medicine
• Orthopedic Surgery
• Health Services Research

Background:

• Hip fractures are a significant health concern in the elderly, leading to high rates of morbidity and mortality.
• The National Hip Fracture Database (NHFD) was established to standardize and improve the quality of care for hip fracture patients.

Purpose of the Study:

• To evaluate the impact of implementing the NHFD on the quality of hip fracture care.
• To compare care pathways and outcomes before and after the introduction of the NHFD audit.

Main Methods:

• A retrospective audit of hip fracture patient care pathways over one year.
• Comparison of data from two six-month periods (initial audit vs. re-audit) against BOA-BGS 'Blue Book' guidelines.

Main Results:

• Significant improvements were observed in period 2 (re-audit) compared to period 1 (initial audit).
• More patients received falls assessments and bone protection interventions (p<0.01).
• Reduced surgical delays (p=0.01), shorter length of stay (p<0.01), and increased adherence to the best practice tariff (70.3% vs. 45.3%, p<0.001) were noted.

Conclusions:

• Implementation of the NHFD audit demonstrably improved hip fracture care quality, aligning with national standards.
• Re-auditing led to shorter times to surgery and hospital stays, with a trend towards lower mortality.
• The NHFD initiative offers potential for improved patient outcomes and significant financial benefits for healthcare institutions.