Key result
Orthogeriatric shared care linked to ~28% greater return to admission source after hip fracture.
Why the study?
A unique orthogeriatric shared care model for hip fracture patients was implemented to improve quality of care and clinical outcomes compared to the previous model.
Does an orthogeriatric model of shared care improve clinical outcomes and staff satisfaction in hip fracture patients?
Cohort (n=523)
No
Does an orthogeriatric model of shared care improve clinical outcomes and staff satisfaction in hip fracture patients?
Absolute Event Rate: 72.7% vs 56.8%
p-value: p=0.00007
An orthogeriatric shared care model for hip fracture patients significantly improves the likelihood of returning to the original source of admission and is preferred by staff.
Orthogeriatric shared-care model may improve discharge destination and staff satisfaction in hip fracture patients; leaves open generalizability beyond this single-center cohort.
BACKGROUND: In August 2010, a unique model of shared care for hip fracture patients was implemented in our hospital. In this model, patients are allocated to an orthogeriatric team within 48 h of surgery, who review patients daily to manage medical complications and coordinate multidisciplinary rehabilitation, with orthopaedic input if necessary. AIM: To compare the new model to the previous model of care as perceived by members of staff and compare clinical outcomes. METHODS: Prospective data were collected using questionnaires given to medical, nursing and allied health professionals. Their opinions were rated using the Likert scaling system and analysed with the Mann Whitney U-test. Clinical outcomes were obtained from the hip fracture database and subsequently analysed. RESULTS: 59 responses (100%); 21 doctors and 38 allied health professionals. The majority of staff believed that quality of patient care was better in the newer model and preferred to work in this model. The median length of stay in the previous model (274 patients) was 25 days compared to 19.5 days in the new model (249 patients) (p = 0.22). 56.8% patients returned to their source of admission in the previous model compared to 72.7% in the new model (p = 0.00007). The inpatient mortality rates improved from 12.4% in the previous model to 8.4% in the new model (p = 0.26). CONCLUSION: This unique model improved care for hip fracture patients and was cost effective. Furthermore, it highlighted excellent staff satisfaction. This can pioneer a change in the management of hip fracture patients nationally and internationally.
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Bhattacharyya et al. (2013) conducted a cohort in Hip fracture (n=523). Orthogeriatric model of shared care vs. Previous model of care was evaluated on Return to source of admission (p=0.00007). An orthogeriatric shared care model for hip fracture patients significantly increased the rate of return to the source of admission compared to the previous model (72.7% vs 56.8%, p=0.00007).
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