Key Service Improvements After the Introduction of an Integrated Orthogeriatric Service

Geriatr Orthop Surg Rehabil. 2019 Dec 11:10:2151459319893898. doi: 10.1177/2151459319893898. eCollection 2019.

Abstract

Introduction: 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.

Methods: 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.

Results: 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; P < .05). A higher proportion of patients were admitted to rehabilitation (16.7% vs 7.9%, P < .05), and this happened in a timelier fashion (17.8 vs 24.8 days, P < .05). We found that less patients required convalescence post-hip fracture.

Discussion: A standardized approach to integrated post-hip fracture care with orthogeriatrics has improved standards of care for patients.

Conclusion: Introduction of orthogeriatric services has resulted in meaningful improvements in clinical outcomes for older people with hip fractures.

Keywords: fragility fractures; hip fractures; integrated care; orthogeriatric care; rehabilitation; systems of care; trauma surgery.