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Implementation Evaluation of an Early Notification Care Bundle for Patients with Hip Fracture (eHIP)
Kate Curtis1,2, John McKenzie3, Geoffrey Melville4,5
1Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
Gerontology
|March 7, 2024
Summary
The early hip fracture activation and care bundle (eHIP) program improved adherence to clinical standards for older adults with hip fractures. This multidisciplinary approach enhanced patient care and outcomes without increasing treatment costs.
Area of Science:
- Geriatric Medicine
- Health Services Research
- Clinical Quality Improvement
Background:
- Hip fractures in older adults lead to high mortality and significant healthcare costs.
- Adherence to clinical care standards for hip fractures is variable.
- Effective implementation strategies are needed to improve hip fracture management.
Purpose of the Study:
- To evaluate the implementation and effectiveness of a multidisciplinary early activation mechanism and bundle of care (eHIP).
- To assess the impact of eHIP on patient outcomes and health service efficiency.
- To determine the extent to which eHIP improves adherence to the Australian Commission for Quality and Safety in Health Care (ACSQHC) Hip Fracture Clinical Care Standard.
Main Methods:
- A controlled pre- and post-test study design was employed.
- The study was conducted at a large regional hospital in Australia from June 2019 to June 2021.
- The study included 565 hip fracture cases for analysis, comparing outcomes before and after eHIP implementation.
Main Results:
- eHIP pathway activation was sustained at 88% over 12 months post-implementation.
- The proportion of patients receiving six or more care components increased from 36% to 49%.
- Significant improvements were observed in pain and cognitive assessment, mobilization, and analgesia prescription, including fascia iliaca block use.
Conclusions:
- The eHIP program, integrating evidence-based behavior change theory, achieved sustained improvements in hip fracture patient care.
- eHIP effectively enhanced adherence to the ACSQHC Hip Fracture Clinical Care Standard.
- The multidisciplinary approach demonstrated positive impacts on patient care processes without altering acute treatment costs.
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