Hip Fracture Unit Clinical presentation to Trust board Dr I - - PowerPoint PPT Presentation
Hip Fracture Unit Clinical presentation to Trust board Dr I Wilkinson, Dr T Giokarini-Royal 22 December 2016 An Associated University Hospital of Brighton and Sussex Medical School Introduction 500 patients per year December 2015 to
Admitted from December 2015 to November 2016 Local% SHA% National% Own home/sheltered housing 79.6 81.1 80.9 Residential care 12.0 9.7 11.1 Nursing care 7.3 9.1 7.8 December 2015 to November 2016 Local SHA National Avg time to orthopaedic ward (hrs) 8.8 12.1 9.9 Avg time to theatres (hrs) 25.1 29.0 31.7 Avg Trust length of stay (days) 19.2 19.8 20.1
5 10 15 20 25 30 35 40 45 50 60-70 70-80 80-90 >90
ESH Local National
Surgery in <36 hours Ortho- geriatric review in 72hrs Admitted on joint care protocol Pre and post op AMTS Falls and bone health assessment MDT assessment
Proposed BPT
A nutritional assessment during the admission Persistence with bone treatment after discharge A delirium assessment during the admission
Assessed by physiotherapist the day following surgery Surgery in <36 hours Orthogeriatric review in 72hrs Pre op AMTS Falls and bone health assessment
Joint Protocol MDT
assesment
Post op AMTS
0% 20% 40% 60% 80% 100%
Dynamic Pain Score IV Paracetamol Pre-operative Nerve Block Post-Operative Pain Measured Pre-Operative NHFS 4AT @ 24-36 hrs Post-Operative 4AT @ 4-7 days Post-Operative Patient Able to Stand Day One Initial Physiotherapy Goals Set CQS ACS Data Completeness
ESU Rate KSS Rate
Day 4 delirium assessment
0% 20% 40% 60% 80% 100% Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16 Sep-16 East Surrey Hospital KSS 0% 20% 40% 60% 80% 100% Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16 Sep-16 East Surrey Hospital KSS 0% 20% 40% 60% 80% 100% Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16 Sep-16 East Surrey Hospital KSS
Pre-op nerve block insertion Post operative pain assessment