A multidisciplinary effort to boost look after older patients who reach the er with a hip fracture has decreased enough time before they will have surgery, shortened hospital stays, and led to better follow-up care, UT Southwestern physicians reported in Geriatric Nursing.
In February 2021, UTSW launched an orthopedic surgery fracture liaison service, Returning Seniors to Orthopedic Excellence (RESTORE), focused largely on prioritizing early pain management and reducing time and energy to surgery for geriatric patients with hip fractures. A team led by Megan Sorich, D.O., Assistant Professor of Orthopaedic Surgery, then integrated the RESTORE program with the prevailing nursing programNurses Improving Look after Healthsystem Elders (NICHE)which aims to standardize early ambulation, delirium assessment and management, hospital room protocols for better orientation and healing, and improve follow-up visit adherence.
Dr. Sorich, a geriatric orthopedic surgeon and first writer of this article, said it’s high time for more collaborative care of hip fractures, the most typical life-altering orthopedic injury among older adults. A lot more than one-third of women living until age 80 will sustain a hip fracture.
“As our population continues to age, more vulnerable patients will require better managed care, and better safety nets,” Dr. Sorich said. “By putting programs such as this in place, hopefully that we might help other institutions deliver this aswell.”
Under RESTORE and NICHE, the collaborative care team for hip fracture patients includes physicians in emergency medicine, internal medicine, geriatrics, anesthesiology, and pain management, in addition to nutritionists, physical and occupational therapists, discharge planning coordinators, geriatric resource nurses and geriatric patient care associates.
Data on 117 patients treated because the RESTORE program launched implies that time and energy to surgery declined from 44 hours to 18, and attendance at post-discharge follow-up visits rose from 40% to 70%, in comparison to a 30% national average, based on the article. Amount of stay dropped from 8.72 days to 7.6 days.
Dr. Sorich said other hospitals could benefit by implementing similar programs. She said the main element to success, after buy-in and support from hospital administrators, is having stakeholders in the geriatric medicine team and also orthopedic surgery team committed to the program right away. Additionally it is a significant advantage to possess all hip fracture patients on the same floor, which UTSW did.
More info: Megan Sorich et al, Creating a comprehensive geriatric fracture program and using evidence-based Nurses Improving Look after Healthsystem Elders (NICHE) best care practices, Geriatric Nursing (2022). DOI: 10.1016/j.gerinurse.2022.05.007
Citation: UT Southwestern geriatric fracture initiatives bring about expedited care and shorter hospital stays (2022, September 3) retrieved 4 September 2022 from https://medicalxpress.com/news/2022-09-ut-southwestern-geriatric-fracture-result.html
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