1111 Care of Elderly Patients with Fractured Hips in an Outlying Ward When Compared to an Others in a Dedicated Hip Fracture Ward

Aim Hip fractures are a significant burden in the UK with roughly 80,000 cases reported per year. The standard of care in our unit is for patients to be admitted to a dedicated hip fracture unit. During busy periods, sometimes patients are admitted to outlying wards and we were concerned that the standard of care was not equivalent to those admitted to the specialist unit. We wanted to identify if this had an impact on their care. Method A retrospective audit was conducted from our prospectively collected database. All hip fracture patients over 60 in the outlier wards were included. We adopted the REDUCE hip fracture outlier audit tool. We compared to a cohort of patients on the main hip fracture ward over a 4-month period. Results During the study period, there were 54 outliers out of total 273 admissions. All outliers were due to a lack of beds in the main ward rather than a clinical indication. 41% of them did not receive surgery within 36 hours. On the first postoperative day, 24% were not mobilised. There was a 2% mortality, and 18% did not receive appropriate bone strengthening treatment before discharge. These outcomes were worse in the outlying ward when compared to the main hip fracture ward. Conclusions Patients on outlier ward did not achieve many of the REDUCE targets and performance was not as good as with patients admitted onto the specialist ward. Certain elements of the findings were lower than the key performance index of the national hip fracture database.