Heartbeat: Fractured Neck of Femur: Breaking the cycle

June 18, 2021

Amongst elderly patients, hip fractures are associated with an in-hospital mortality rate of 7–14 per cent nationally, and often result in profound temporary and sometimes even permanent impairment of independence and quality of life. With an aging population, global pandemic creating chaos on an unprecedented level, it’s important that we break the cycle of broken hips becoming broken lives. And at our Trust, we proud to announce, we have ‘smashed’ the best practice for four consecutive months.

The hip fracture guideline published by NICE emphasises the importance of early treatment of hip fracture patients. With hip fracture surgery often subject to delay in comparison with other operations surgery is still considered the best form of pain relief. Postponement of surgery prolongs pain and carries an increased risk of complications.

Despite the challenges that we have faced this year as a Trust, the specialist surgery directorate is proud to announce that it has met the Fractured Neck of Femur Best Practice tariff target of surgery within 36 hours for the past four months and on target to complete the fifth month.

Sharing their news, Specialist Surgery Directorate General Manager Natasha Dupree said, “We have a cohesive multidisciplinary team dedicated to the management and care of Neck of Femur (NOF) patients including orthopaedic consultants, an ortho-geriatrician, nursing staff, trauma coordinators, anaesthetists, physiotherapists, theatre staff, and management. This team meets bi-weekly to review patient pathways, undertake a root cause analysis of any breaches and to identify areas of opportunity of improvement and themes in avoidable breaches.

“A significant aspect of meeting the best practice target has been down to our excellent and refreshed team of Trauma Coordinators who work 7 days a week proactively overseeing the NOF pathway and ensuring maximum utilisation and efficient listing of trauma surgery.

“In November 2020 we established a working group outlining an improvement plan. The plan includes several task and milestones including the development of a trauma surgery standard operating procedure, routine review of breaches and improved data capture. Going forward, we will be continuing this work over the next few months to improve the digital management of NOF patients including the development of KPIs across the pathway that we can regularly report on and monitor. We are also planning the development of a Unity pro-forma to enable robust reporting on NOF KPIs and creating alerts within Unity to support proactive management. As a team we will be preparing for MMUH and mapping the pathway to our new hospital, identifying opportunities for further improvement”