title: Protocol-guided hip fracture management  reduces length of hospital stay.
abstract: OBJECTIVE
  To see if protocolised hip fracture care led to an improvement in patient management and more standardized treatment with the aim of reducing wait for surgery and postoperative length of stay.
  
  
  METHODS
  Following the introduction and establishment of a care pathway a retrospective, observational audit was conducted with patient data and pathway compliance obtained from analysing medical notes and accessing electronic patients' records.
  
  
  METHODS
  The audit analysed all patients who sustained a fractured hip admitted to University College London Hospital over 18-month period between August 2009 and February 2011.
  
  
  METHODS
  In addition to demographic data, a comparison was made between those who were and were not managed with the care pathway. Investigation, preoperative management, time to surgery, length of stay and mortality were all evaluated.
  
  
  RESULTS
  Patients managed via the care pathway had significantly more investigations and preoperative interventions, had subsequently had a reduced length of hospital stay (a mean average of 13 compared to 17 days). There was no significant difference in time from admission to surgery, and 30-day mortality.
  
  
  CONCLUSIONS
  Using a care pathway to manage those patients sustaining fractured femur appears to make preoperative management more consistent. This, in turn, leads to a reduction in length of hospital stay.
authors.affiliation: Department of Anaesthesia, Royal Free London NHS Foundation Trust, London NW3 2QG, UK. Gautam.kumar@nhs.net
authors.forename: Gautam
authors.initials: G
authors.lastname: Kumar
mesh_terms: D000368:Aged; D002985:Clinical Protocols / Q000592:standards; D019091:Critical Pathways / Q000592:standards*; D057286:Electronic Health Records; D005260:Female; D006620:Hip Fractures / Q000401:mortality / Q000601:surgery; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods / Q000592:standards; D010043:Outcome and Process Assessment, Health Care; D018579:Patient Selection; D019990:Perioperative Care / Q000379:methods*; D017410:Practice Guidelines as Topic; D058996:Quality Improvement; D012189:Retrospective Studies; D061665:Time-to-Treatment / Q000592:standards; D006113:United Kingdom / Q000453:epidemiology; D014850:Waiting Lists