BOSTON'S Pilgrim Hospital has met its target to operate on all hip fracture patients within 36 hours of arrival in Accident and Emergency.
The Pilgrim hip fracture project started in May 2012, following recognition that patients admitted to hospital with fractured neck of femur, hip fracture, were not being given due priority as these patients are often seriously ill, elderly and frail, resulting in poor outcomes.
A team, including Orthopaedic Surgeon Theo Joachim and Trauma Sister Sam Goy, got together to look at how care for these patients could be improved.
Mr Joachim said: “We first looked at all of the national guidance around the care of hip fracture patients, to find out exactly what standards we should be aiming for. This included NICE guidance and data from audits, as well as the national hip fracture database.
“We then put together a protocol for the care of hip fracture patients at Pilgrim, aiming for optimum patient care.”
The next step was to involve all of the teams who have contact with these patients during their journey through hospital, to ensure they were correctly prioritising hip fracture patients and giving them tailored care.
This included work with A and E, geriatricians, orthopaedic surgeons, anaesthetists, X-ray staff, trauma ward nurses, porters, occupational therapists and physiotherapists.
Mr Joachim added: “We now have a system in place where hip fracture patients are identified as soon as they come to A and E, so they don’t wait around but are taken straight up to the ward. They are then cared for by staff who have specialist training in this area and are prioritised for diagnostic X-rays and also for surgery, with dedicated trauma lists in theatres.
“The ortho-geriatricians play an integral role in the peri-operative care and our expert anaesthetists and surgeons provide state of the art surgery.
“It is then down to the ward staff and the occupational therapists and physiotherapists to get these patients up and moving again. Although for some of these patients the hip fracture may be a terminal event, prompt intervention by the team provides relief of pain and distress and often returns them to familiar surroundings.”