One year later: did the quality circle of geriatric hip fracture care achieve quality outcomes?
In 1 year, the Geriatric Orthopaedic Hip Fracture Program saw various positive results. The accomplishments are as follows: Appropriate use of consulting services. Reduction in the mortality rate. Increase in the number of patients (76%) who returned to home versus skilled nursing facilities. Reduction of LOS. Fifty-seven percent of patients are independent with ADLs at 6 months after hip fracture repair. Sixty-four percent remain independent ambulators and use aids on an as needed basis. Our team has learned that we need to improve certain areas of the program. We need to reinforce to the staff the importance of following skin care and toileting guidelines. Other research articles looking at the overall condition of the geriatric patient have used the Apache score or the Anesthesia Rating score and we plan to follow suit. The Apache and Anesthesia ratings have been used to predict outcomes; the higher the score, the less successful the outcome. Within the cost structure, we needed to become more aware of the comorbidity costs and identify opportunities to address these issues.
Leininger
S M
SM
Orthopedics and Urology Services, West Penn Allegheny University Hospitals, Pittsburgh, USA.
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D019090:Case Management / Q000458:organization & administration*; D005260:Female; D006620:Hip Fractures / Q000150:complications / Q000451:nursing*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008332:Management Quality Circles / Q000458:organization & administration*; D017063:Outcome Assessment, Health Care / Q000458:organization & administration*; D010348:Patient Care Team / Q000458:organization & administration; D010359:Patient Readmission / Q000706:statistics & numerical data; D015397:Program Evaluation