A multi-disciplinary, protocolised care for hip fracture surgeries shortens hospital stay, time to admission and surgery

Background Our institution implemented a multi-disciplinary protocolised care for surgically managed hip fractures in 2017, initiating measures pre-operatively to provide early access to surgery, and post-operatively to ensure early mobilisation and smooth transition to step down care. Objectives Ke...

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Main Authors: Khai Cheong Wong, Gideon Jia Wei Cheok, Kenny Xian Khing Tay, Joyce Suang Bee Koh, Tet Sen Howe, Yeong Huei Ng
Format: Article
Language:English
Published: SAGE Publishing 2025-01-01
Series:Proceedings of Singapore Healthcare
Online Access:https://doi.org/10.1177/20101058251318761
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author Khai Cheong Wong
Gideon Jia Wei Cheok
Kenny Xian Khing Tay
Joyce Suang Bee Koh
Tet Sen Howe
Yeong Huei Ng
author_facet Khai Cheong Wong
Gideon Jia Wei Cheok
Kenny Xian Khing Tay
Joyce Suang Bee Koh
Tet Sen Howe
Yeong Huei Ng
author_sort Khai Cheong Wong
collection DOAJ
description Background Our institution implemented a multi-disciplinary protocolised care for surgically managed hip fractures in 2017, initiating measures pre-operatively to provide early access to surgery, and post-operatively to ensure early mobilisation and smooth transition to step down care. Objectives Key performance indicators (time to admission and time to surgery) and acute outcomes (length of stay, discharge disposition and inpatient mortality) were evaluated to determine the impact of multi-disciplinary protocolised care on surgically managed hip fracture patients. Methods 935 patients in the POST-PROTOCOL group (between February 2017 to January 2020) were compared with 701 patients in the PRE-PROTOCOL group (between January 2015 to January 2017) in terms of key performance indicators and acute outcomes. Results In the POST-PROTOCOL group, a higher proportion were of ASA class III and IV ( p = .026). More patients in the POST-PROTOCOL group were admitted to the ward within 4 hours (97.2% vs 86.0%; p < .001) and operated on within 48 hours (56.4% vs 36.8%; p < .001). Mean length of stay was shorter in the POST-PROTOCOL group (11.2 ± 9.0 vs 14.8 ± 13.0 days; 95% CI, 2.5 to 4.7; p < .001), with more patients discharged within 9 days (55.6% vs 43.2%; p < .001). Inpatient mortality rate was similar ( p = .213). Conclusion Despite having a higher proportion of patients with poorer physiological status, time to admission, time to surgery and length of stay improved in the POST-PROTOCOL group.
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spelling doaj-art-9bacf35f1648433e8026d34348cf7f7a2025-02-04T02:03:20ZengSAGE PublishingProceedings of Singapore Healthcare2059-23292025-01-013410.1177/20101058251318761A multi-disciplinary, protocolised care for hip fracture surgeries shortens hospital stay, time to admission and surgeryKhai Cheong WongGideon Jia Wei CheokKenny Xian Khing TayJoyce Suang Bee KohTet Sen HoweYeong Huei NgBackground Our institution implemented a multi-disciplinary protocolised care for surgically managed hip fractures in 2017, initiating measures pre-operatively to provide early access to surgery, and post-operatively to ensure early mobilisation and smooth transition to step down care. Objectives Key performance indicators (time to admission and time to surgery) and acute outcomes (length of stay, discharge disposition and inpatient mortality) were evaluated to determine the impact of multi-disciplinary protocolised care on surgically managed hip fracture patients. Methods 935 patients in the POST-PROTOCOL group (between February 2017 to January 2020) were compared with 701 patients in the PRE-PROTOCOL group (between January 2015 to January 2017) in terms of key performance indicators and acute outcomes. Results In the POST-PROTOCOL group, a higher proportion were of ASA class III and IV ( p = .026). More patients in the POST-PROTOCOL group were admitted to the ward within 4 hours (97.2% vs 86.0%; p < .001) and operated on within 48 hours (56.4% vs 36.8%; p < .001). Mean length of stay was shorter in the POST-PROTOCOL group (11.2 ± 9.0 vs 14.8 ± 13.0 days; 95% CI, 2.5 to 4.7; p < .001), with more patients discharged within 9 days (55.6% vs 43.2%; p < .001). Inpatient mortality rate was similar ( p = .213). Conclusion Despite having a higher proportion of patients with poorer physiological status, time to admission, time to surgery and length of stay improved in the POST-PROTOCOL group.https://doi.org/10.1177/20101058251318761
spellingShingle Khai Cheong Wong
Gideon Jia Wei Cheok
Kenny Xian Khing Tay
Joyce Suang Bee Koh
Tet Sen Howe
Yeong Huei Ng
A multi-disciplinary, protocolised care for hip fracture surgeries shortens hospital stay, time to admission and surgery
Proceedings of Singapore Healthcare
title A multi-disciplinary, protocolised care for hip fracture surgeries shortens hospital stay, time to admission and surgery
title_full A multi-disciplinary, protocolised care for hip fracture surgeries shortens hospital stay, time to admission and surgery
title_fullStr A multi-disciplinary, protocolised care for hip fracture surgeries shortens hospital stay, time to admission and surgery
title_full_unstemmed A multi-disciplinary, protocolised care for hip fracture surgeries shortens hospital stay, time to admission and surgery
title_short A multi-disciplinary, protocolised care for hip fracture surgeries shortens hospital stay, time to admission and surgery
title_sort multi disciplinary protocolised care for hip fracture surgeries shortens hospital stay time to admission and surgery
url https://doi.org/10.1177/20101058251318761
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