Emory Decatur Hospital and Emory Hillandale Hospital have developed a hip fracture program that allows patients suffering from a hip fracture to undergo surgery within 24 hours from arrival in the Emergency Department.
Prior to having this program in place, if a hip fracture patient came in through the Emergency Department, they may have to wait three to five days for surgery. However by having a dedicated program in place, much needed surgery is provided for that patient sooner, usually reducing further complications and readmissions rates.
Orthopedic surgeon Nathan Jove, MD, states, “The program was started because hip fracture patients were not seen as an urgent need, but as a routine case. Studies confirm that waiting for greater than 30 hours for surgery can drastically increase the risk of complications post-surgery. Now we have a team in place that makes sure that patient is undergoing surgery within 24 hours.”
Coordinated care amongst Emergency Department hospitalists, orthopedic surgeons, an orthopedic nursing staff, anesthesia, therapists and care management staff provide optimal care for the patient during and post-discharge. Communication between parties to make sure the patient has surgery within 24 hours that include specific treatment guidelines and protocol, including the involvement of a care management team, has drastically reduced the length of stay for the patient. Physical therapists meet with the patient to provide strength and mobility exercises. The use of a Femoral Nerve Block for pain control provides postoperative pain management and limits the use of opioids.
Matt Glogowski, program manager for the Joint Solutions Center at Emory Decatur Hospital notes, “Our dedicated team has been instrumental in the development of a formal hip fracture treatment program. Our program has now medically optimized the fracture patient leading to: early recognition and orthopedic consult, early pain reduction without the use of strong opioid medications, early surgical intervention (less than 24 hours from ED to the OR), and early mobilization with physical therapy all leading to a decreased length of stay in the hospital, low complication rate, improved patient satisfaction, but more importantly, better outcomes and greater functional ability for our fracture patients.”
Overall, having a dedicated multidisciplinary team approach and care pathway protocol allows for the successful treatment and patient outcome of hip fractures.
- Program launched April 2018
- Number of patients through the program: 40+
- Medium time to surgery: 23 hours
- Average LOS: 4.04 days
- Femoral Nerve Block use for pain management
- Early ambulation with use of therapy rehabilitation
- A dedicated multi-disciplinary team providing best outcomes for hip fracture patients