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Defining optimal orthogeriatric hip fracture care: a delphi consensus approach
H E van Bremen1,2,3, L J Seppala3,4, E A Gans5,6
1Amsterdam Bone Center, Movement Sciences Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
European Geriatric Medicine
|February 5, 2025
Summary
This study developed consensus-based recommendations for orthogeriatric hip-fracture care, identifying core and optimal elements for hospitals. The findings aim to reduce variability in managing hip fractures in older adults.
Area of Science:
- Geriatric Medicine
- Orthopaedic Surgery
- Healthcare Management
Background:
- Hip fractures are a significant health concern for older adults.
- Orthogeriatric care models aim to improve outcomes for these patients.
- Variability exists in current hip fracture care delivery.
Purpose of the Study:
- To establish consensus-based recommendations for core and optimal elements of orthogeriatric hip-fracture care.
- To provide practical guidance for implementing orthogeriatric care.
- To reduce clinical management variability in hip fracture patients.
Main Methods:
- An online Delphi survey was conducted in the Netherlands.
- 72 statements covering all care phases for hip fracture patients were evaluated.
- Consensus was defined as >75% agreement among 63 (round 1) and 55 (round 2) participants, including geriatricians, trauma surgeons, and patient representatives.
Main Results:
- Consensus was achieved on 48 statements for minimal orthogeriatric care.
- Consensus was reached on 60 statements for optimal orthogeriatric care.
- Participants predominantly had backgrounds in geriatrics (36%) and trauma surgery/orthopaedics (20%).
Conclusions:
- The study supports existing recommendations and offers practical implementation guidance for orthogeriatric care.
- Recommendations address core and optimal elements for hospitals at various stages of development.
- Organizational and logistical factors are identified as barriers to optimal care delivery.
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