Background: Hip fractures are the most common cause of acute admission to an orthopaedic ward. There is a 20–24% mortality rate within one year, as many of the patients who sustain hip fractures have multiple comorbidities, are frail and elderly. In ireland in 2017, 3,608 patients over the age of 60 hospitalised with hip fractures. The aim of the Irish Hip Fracture Standards (IHFS) are to drive continuous quality improvement for better, safer care of the eldery hip fracture patient.
Methods: We used the Irish hip fracture database (IHFD) to extract data on all the hip fractures admitted to Connolly Hospital Blanchardstown (CHB) over a 1-year period in 2019. We assessed compliance with IHFS 4, 5 and 6 in the initial 6 months of that period. The impact of an orthogeriatric service at the 6-month mark on compliance with these standards was then analysed.
Results: The first cycle of the audit looked at IHFS 4, 5 and 6 for all hip fractures admitted from January to July 2019. The second cycle of the audit reviewed the same standards following the introduction of an orthogeriatric service. So far, the number of orthogeriatric reviews (IHFS 4) increased from 34% to 50% of all hip fracture admissions. Bone health assessments (IHFS 5) increased from 66.7% to 75%. Falls assessments (IHFS 6) increased from 30.1% to 50%.
Conclusions: There has been a significant improvement in the IHFS 4, 5 and 6 since the introduction of an orthogeriatric service in CHB. Recommendations to further improve these statistics include scheduled orthogeriatrician lead ward rounds on a bi-weekly basis. The aim is to reduce risks associated with the hip fracture patient, reducing inpatient length of stay and ultimately improve patient outcomes long term.
