National Hip Fracture Database Kuntal Patel MS(Orth), MRCS(Ed.), - - PowerPoint PPT Presentation

National Hip Fracture Database

Kuntal Patel MS(Orth), MRCS(Ed.), Dip SEM (GB & I), MSc (Sports Injuries), MSc (Orthopaedics), FRCS (T & O) Consultant Orthopaedic Surgeon Honorary senior clinical lecturer – Edge Hill University

Regional Data for North West Hospitals

120 121 157 164 206 229 247 249 273 319 354 382 400 403 458 50 100 150 200 250 300 350 400 450 500

Number of submitted # Fracture NOF

Measures taken in the last 12 months

• Hip Fracture pathway
• Regular MDT
• Training of nurses for AMTS assessment
• Junior doctor education
• Robust induction
• Increase in no. of T/L
• Consultant lead for trauma

Time to Surgery <36 hours

56% 55% 73% 68% 57% 84% 0% 20% 40% 60% 80% 100% April 2010 - March 2011 (RLI n=264 FGH n=102) April 2011 - March 2012 (RLI n=282 FGH n=125) April 2012 - Dec 2012 (RLI n=186 FGH n=91) RLI FGH

Reason if >36 hours RLI

61% 55% 49% 20% 21% 31% 9% 11% 14% 9% 12% 6% 0% 20% 40% 60% 80% 100% April 2010 - March 2011 (n=116) April 2011 - March 2012 (n=123) April 2012 - Dec 2012 (n=51) Theatre space Medical review Ortho review Other

Reason if >36 hours FGH

28% 40% 7% 31% 24% 40% 10% 7% 31% 29% 53% 0% 20% 40% 60% 80% 100% April 2010 - March 2011 (n=29) April 2011 - March 2012 (n=42) April 2012 - Dec 2012 (n=15) Theatre space Medical review Ortho review Other

Specialist Falls Assessment

1% 87% 99% 0% 98% 100% 0% 20% 40% 60% 80% 100% April 2010 - March 2011 (RLI n=264 FGH n=102) April 2011 - March 2012 (RLI n=282 FGH n=125) April 2012 -Dec 2012 (RLI n=186 n=91) RLI FGH

Bone Medication Assessment

25% 69% 95% 29% 100% 100% 0% 20% 40% 60% 80% 100% April 2010 - March 2011 (RLI n=264 FGH n=102) April 2011 - March 2012 (RLI n=282 FGH n=125) April 2012 - Dec 2012 (RLI n=186 FGH n=91) RLI FGH

Admitted using joint protocol

68% 97% 98% 100% 0% 20% 40% 60% 80% 100% April 2011 - March 2012 (RLI n=282 FGH n=125) April 2012 - Dec 2012 (RLI n=186 FGH n= 91) RLI FGH

Geriatrician assessment <72 hours

46% 78% 59% 93% 0% 20% 40% 60% 80% 100% April 2011 - March 2012 (RLI n=282 FGH n=125) April 2012 - Dec 2012 (RLI n=186 FGH n=91) RLI FGH

MDT rehab assessment

66% 92% 98% 98% 0% 20% 40% 60% 80% 100% April 2011 - March 2012 (RLI n=282 FGH n=125) April 2012 - Dec 2012 (RLI n=186 FGH n=91) RLI FGH

Pre-op AMTS

82% 89% 0% 20% 40% 60% 80% 100% April 2012 - Dec 2012 (RLI n=171 FGH n=81) RLI FGH

Pre-op AMTS

55% 87% 93% 72% 88% 97% 0% 20% 40% 60% 80% 100% Q1 Q2 Q3 RLI FGH

Post-op AMTS

54% 85% 0% 20% 40% 60% 80% 100% April 2012 - Dec 2012 (RLI n=171 FGH n=81) RLI FGH

Post-op AMTS

28% 49% 79% 56% 96% 92% 0% 20% 40% 60% 80% 100% Q1 Q2 Q3 RLI FGH

Pressure ulcers

0.5 0.8 0.9 1 1.3 2.1 2.3 2.9 3.4 3.9 4.4 4 5 7.5 8.8 1 2 3 4 5 6 7 8 9 10

Bone protection medication

31.7 31.8 64 80.3 86.8 90.7 92 92.3 94.1 96.2 96.5 96.5 97.1 99.6 100 20 40 60 80 100 120

Surgery within 48hrs and during working hours

61.4 65.8 70.2 70.3 71.9 73.6 75.3 75.7 78.2 82.4 83.2 88.6 92.2 92.4 93.8 10 20 30 40 50 60 70 80 90 100

RLI vs England

52.2 73.6 23.8 0.9 89.8 64 13.8 8.5 22.3 49.9 84.2 49.8 4 92.8 93.1 15.8 3.9 19.7 10 20 30 40 50 60 70 80 90 100 Royal Lancaster Infirmary English average

Conclusion

 Hip fractures are the commonest serious injury of older people which result in increased morbidity and mortality  The safe, effective, and timely management of patients presenting with hip fractures is fundamental in the practice of Trauma & Orthopaedic Surgery  Multi-disciplinary approach and understanding of collective goals and objectives in management are essential  Improvements in the rate of achievement of BPT measures will not only lead to higher quality of care for patients with hip fractures, but also additional funding for the department

Thank you