Comprehensive Hip Fracture Care Program: Successive Implementation in 3 Hospitals

Area of Science:

• Geriatric Medicine
• Orthopedic Surgery
• Healthcare Management

Background:

• Hip fractures represent a significant health burden in the elderly, leading to functional decline and increased healthcare costs.
• Prompt and coordinated surgical intervention is crucial for improving outcomes in this vulnerable population.

Purpose of the Study:

• To evaluate the impact of an interdisciplinary Hip Fracture Care program (HFCP) on surgical timing and length of stay.
• To assess the effectiveness of a streamlined care pathway for elderly hip fracture patients.

Main Methods:

• An interdisciplinary care program was implemented across three hospitals.
• The study compared outcomes (time to surgery, length of stay, discharge location) pre- and post-intervention using interrupted time series analysis.
• Inclusion criteria focused on patients over 65 with hip fractures (specific MS-DRG codes).

Main Results:

• Mean length of stay decreased by 0.9 days (from 5.6 to 4.7 days, P < .05).
• Mean time from admission to surgery reduced by 5.2 hours (from 30.8 to 25.6 hours, P < .05).
• No significant change was observed in discharge disposition (home vs. skilled nursing facility).

Conclusions:

• An interdisciplinary, multifactorial hip fracture care program can significantly shorten time to surgery and reduce hospital length of stay.
• Optimizing hip fracture care pathways is essential for improving efficiency and outcomes in elderly patients.