Scaling up for safety: standardising the lessons learnt from a hip fracture quality improvement programme

  • Led by Northumbria Healthcare NHS Foundation Trust, in partnership with the British Orthopaedic Association and Academic Health Science Network for the North East and Cumbria, with evaluation by the Royal College of Physicians.
  • Being implemented in five NHS hospital trusts in England, Wales and Northern Ireland.
  • Aiming to improve care for hip fracture patients via a multidisciplinary, pathway approach.
  • Involves replicating the learning from HIP QIP, a successful hip fracture quality improvement project.

Hip fracture is common – almost 65,000 people were admitted to hospital with a fractured hip in 2015. Nearly a third of people who fracture their hip will die within a year, and a fifth of patients won’t return to their own home. In addition, the cost of care is high and is set to rise sharply as the population continues to age.

High quality safe care requires the coordinated effort of a multidisciplinary team, and the implementation of best practice, evidence-based care.

Northumbria Healthcare NHS Foundation Trust’s hip fracture quality improvement programme (HIP QIP) has been running for five years and has been very successful. Hip fracture patients at the trust are now far more likely to survive, have faster access to information, imaging and surgery, and receive better pain management and early physiotherapy seven days a week.

The programme included establishing a multidisciplinary audit framework; prioritising additional nutrition for patients with hip fracture; implementing a surgical care bundle, pain block in A&E and surgery within 36 hours; and carrying out root cause analysis of any deaths.

This project involves replicating the learning from HIP QIP by supporting four other acute hospital trusts who are currently struggling to provide safe, high quality hip fracture care to patients. The sites will be selected based on poor outcomes in the National Hip Fracture Database annual report.

The project aims to help these sites to provide hip fracture care of the highest quality, ensure recent evidence and national standards are systematically implemented, and provide improved patient experience.

Contact details

For more information about this project, pease email Professor ​Mike Reed, Clinical Lead for Quality at Northumbria Healthcare NHS Foundation Trust.

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