title: The Eastbourne Trauma Assisted Discharge Scheme (TADS) Reduces Length of Stay in Hip Fracture Patients.
abstract: PURPOSE OF THE STUDY The aim of this prospective study; The Trauma Assisted Discharge Scheme (TADS), was to set up a new model of postoperative care for patients following a fractured hip, addressing the need for efficiency, cost effectiveness and meeting local demand. MATERIAL AND METHODS All patients with hip fractures between December 2010 and December 2011, meeting the TADS inclusion criteria were enrolled in the study. Innovative use of staff within existing budgets helped create a TAD team who with the use of defined patient goals and a link nurse provided a seamless transition from acute to community services. RESULTS One hundred and sixteen patients followed the TADS pathway; the majority aged 80-89 years and independent prior to falling. A total of 35 patients underwent dynamic hip screw fixation; 55 hemiarthroplasty, 11 total hip replacement and 11 cannulated screw fixation. The average length of in-hospital stay was 8.6 nights. The TADS reduced the average length of stay by 4.78 days. CONCLUSION TADS has the potential to be used as a model of care in other specialities and is easily transferable to the wider NHS.
  
  
  BACKGROUND
  continuous quality improvement, quality improvement, surgery, cost-effectiveness, ambulatory care.
authors.affiliation: Eastbourne District General Hospital, East Sussex Healthcare NHS Trust, Eastbourne, East Sussex, UK.
authors.forename: S
authors.initials: S
authors.lastname: Lidder
authors.forename: B
authors.initials: B
authors.lastname: Hylton
authors.forename: A
authors.initials: A
authors.lastname: Nahhas
authors.forename: S
authors.initials: S
authors.lastname: Rajaratnam
authors.forename: A
authors.initials: A
authors.lastname: Skymre
authors.forename: A
authors.initials: A
authors.lastname: Armitage
mesh_terms: D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip / Q000191:economics / Q000706:statistics & numerical data*; D001863:Bone Screws / Q000706:statistics & numerical data; D003362:Cost-Benefit Analysis; D005260:Female; D005593:Fracture Fixation, Internal / Q000191:economics / Q000706:statistics & numerical data*; D062785:Hemiarthroplasty / Q000191:economics / Q000706:statistics & numerical data*; D006620:Hip Fractures / Q000191:economics / Q000601:surgery*; D006801:Humans; D007902:Length of Stay / Q000639:trends*; D008297:Male; D011182:Postoperative Care; D011446:Prospective Studies; D016896:Treatment Outcome