Key Service Improvements After the Introduction of an Integrated Orthogeriatric Service.

Abstract

Models of orthogeriatric care have been shown to improve functional outcomes for patients after hip fractures and can improve compliance with best practice guidelines for hip fracture care. We evaluated improvements to key performance indicators in hip fracture care after implementation of a formal orthogeriatric service. Compliance with Irish Hip Fracture standards of care was reviewed, and additional outcomes such as length of stay, access to rehabilitation, and discharge destination were evaluated. Improvements were observed in all of the hip fracture standards of care. Mean length of stay decreased from 19 to 15.5 days (mean difference 3.5 days; <i>P</i> < .05). A higher proportion of patients were admitted to rehabilitation (16.7% vs 7.9%, <i>P</i> < .05), and this happened in a timelier fashion (17.8 vs 24.8 days, <i>P</i> < .05). We found that less patients required convalescence post-hip fracture. A standardized approach to integrated post-hip fracture care with orthogeriatrics has improved standards of care for patients. Introduction of orthogeriatric services has resulted in meaningful improvements in clinical outcomes for older people with hip fractures.