Implementing findings from (hip) fracture registries.

Abstract

The National Health Service in England has successfully used learning from its National Hip Fracture Database to drive improvements in care of the most frail orthopaedic trauma patients. While this could simply be viewed as achieving its primary function, the learning with regard to meaningful change that resulted has been applied across the other aspects of trauma to achieve improvements including multiply injured patients within trauma systems (Trauma Audit and Research Network (TARN)) and community level trauma. This work looks at the lessons that can be learned through the inception and running of a national database, in particular how it can be used as a template to achieve improved care in other aspects of orthopaedic trauma. It explains the UK system and the navigation of this to gain political and administrative traction in the creation of a national network and how this momentum was used to achieve a complete overhaul of the trauma system. There are lessons that are applicable across all healthcare systems.