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, the Royal College of Physicians and the Academic Health Science Network for the North East and Cumbria.
- Replicated the learning from HIP QIP, a successful hip fracture quality improvement project, in five NHS hospital trusts in England and Scotland.
- Aimed to improve care for hip fracture patients via a multidisciplinary, pathway approach.
- Interim results show the project has saved 119 lives so far.
Hip fracture is the most common serious injury in older people and costs the NHS and social care £1bn a year. 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.
High quality safe care requires the coordinated effort of a multidisciplinary team, and the implementation of best practice, evidence-based care.
A successful hip fracture quality programme (HP QIP) has been running at Northumbria Healthcare NHS Foundation Trust since 2010. The programme involves 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 Scaling up Improvement project involved replicating the learning from HIP QIP in five acute hospital trusts: Gloucestershire Hospitals NHS Foundation Trust, Great Western Hospitals NHS Foundation Trust, South Teas Hospitals NHS Foundation Trust, Weston Area Health Trust and Queen Elizabeth University Hospital Glasgow.
Teams attended learning events to review the evidence, exchange ideas and discover the potential for improvement. They tested and implemented changes in their local settings, and collected data to measure the impact of the work.
R results show that 119 lives have been saved. This is when comparing the 30-day mortality rates across the four English trusts before the collaborative (9.2%) and after (5.8%).
One hundred extra patients returned to their own home instead of a nursing or residential home; length of hospital stay was reduced by two days, and there was a 10% increase in patients being mobilised on the day of, or day after, their surgery.
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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