title: Geriatric hip fracture management: keys to providing a successful program.
abstract: BACKGROUND
  Hip fractures are a common event in older adults and are associated with significant morbidity, mortality and costs. This review examines the necessary elements required to implement a successful geriatric fracture program and identifies some of the barriers faced when implementing a successful program.
  
  
  METHODS
  The Geriatric Fracture Center (GFC) is a treatment model that standardizes the approach to the geriatric fracture patient. It is based on five principles: surgical fracture management; early operative intervention; medical co-management with geriatricians; patient-centered, standard order sets to employ best practices; and early discharge planning with a focus on early functional rehabilitation. Implementing a geriatric fracture program begins with an assessment of the hospital's data on hip fractures and standard care metrics such as length of stay, complications, time to surgery, readmission rates and costs. Business planning is essential along with the medical planning process.
  
  
  CONCLUSIONS
  To successfully develop and implement such a program, strong physician leadership is necessary to articulate both a short- and long-term plan for implementation. Good communication is essential-those organizing a geriatric fracture program must be able to implement standardized plans of care working with all members of the healthcare team and must also be able to foster relationships both within the hospital and with other institutions in the community. Finally, a program of continual quality improvement must be undertaken to ensure that performance outcomes are improving patient care.
authors.affiliation: Department of Orthopaedic Surgery, VCU Medical Center, 1200 E. Broad St., Richmond, VA, 23298, USA.
authors.forename: N
authors.initials: N
authors.lastname: Basu
authors.affiliation: Department of Orthopaedic Surgery, VCU Medical Center, 1200 E. Broad St., Richmond, VA, 23298, USA.
authors.forename: M
authors.initials: M
authors.lastname: Natour
authors.affiliation: Department of Orthopaedic Surgery, VCU Medical Center, 1200 E. Broad St., Richmond, VA, 23298, USA.
authors.forename: V
authors.initials: V
authors.lastname: Mounasamy
authors.affiliation: Department of Orthopaedic Surgery, VCU Medical Center, 1200 E. Broad St., Richmond, VA, 23298, USA. Stephen.kates@vcuhealth.org.
authors.forename: S L
authors.initials: SL
authors.lastname: Kates
mesh_terms: D000368:Aged; D015577:Geriatric Assessment; D006299:Health Services for the Aged / Q000458:organization & administration* / Q000592:standards; D006620:Hip Fractures / Q000534:rehabilitation / Q000628:therapy*; D006801:Humans; D017146:Models, Organizational; D010348:Patient Care Team / Q000458:organization & administration; D016730:Program Development; D011787:Quality of Health Care / Q000458:organization & administration*
keywords: Geriatric; Hip fracture; Implementation; Management