Over nine in ten hip fracture patients in St. Vincent’s University Hospital receive surgery within 48 hours of emergency admission. Hospital performs well above the national average for treatment of hip fractures – says latest report.

29th November 2018

Over nine in ten hip fracture patients at St. Vincent’s University Hospital received surgery within 48 hours of emergency admission.

Hospital performs well above the national average for treatment of hip fractures

A multi-disciplinary team, trained ambulance crew who ring ahead, 7 day theatre access and regular team meetings are just some of the ingredients that ensure St.Vincent’s University Hospital (SVUH) stays significantly ahead of the national average in the treatment of hip fractures – from initial trauma through to discharge.

The launch today of the Irish Hip Fracture Database National Report 2017 showed that SVUH was the highest performing hospital in a number of key standards to include:

• 92% of patients received surgery within 48 hours of their admission to the Emergency Department – 23% above the national average
• 94% of patients were reviewed by a geriatrician in hospital –  44% above the national average
• 98%  patients received a bone health  assessment to prevent further  fractures, 25% above the national average

Last year, in Ireland, 3,608 patients aged 60 years or over were hospitalised following a hip fracture. Hip fracture patients are typically frail with complex medical and social issues. Nearly 60% are aged 80 and older.  SVUH serves a catchment area of 350,000 – 450,000 people and every year 350—400 people are admitted with a hip fracture making it one of the busiest units for hip fractures in Ireland.

Speaking at the launch, Mr Conor Hurson, Trauma & Orthopaedic surgeon at St. Vincent’s University Hospital said: “One of the most important factors contributing to efficient and successful hip fracture care is how we collaborate with the multitude of difference specialties that make up our multi-disciplinary team.

“Speed, access and expertise  are all essential but a key feature of our system is how we work together with the different experts from  the National Ambulance Service who first call ahead, the Emergency Department, operating theatres, orthopaedic wards, intensive care units as well as nurses, porters, anaesthetists, surgeons, orthogeriatricians, pharmacy and laboratory staff, bed management and administration.

“Regular and formalised meetings and a culture of openness and collaboration have all played a key part in making us one of the highest performing hospitals for the treatment of hip fractures in Ireland”, Hurson continued. 

The ‘Hip Attack’ pathway at St. Vincent’s University Hospital

When a hip fracture is suspected the responding ambulance crew call ahead to inform SVUH’s Emergency Department and the ‘HIP ATTACK’ pathway is initiated. The patient can utilise the “Pitstop” bed, (Monday-Friday, 8am-5pm), where all relevant tests and investigations are carried out prior to transfer to X-RAY. If the radiographer notes a hip fracture, the patient is transferred to a dedicated hip fracture bed prior to being transferred back to ED for a fascia iliaca or nerve block.

Through the use of this pathway the orthopaedic and orthogeriatric teams are notified of the patients’ presence. This allows medical reviews to be completed and further tests to be carried out early, reducing delays to surgery.  The hospital’s 7 day consultant-led trauma list, 8am-6pm also means that hip fracture patients will have 7 day theatre access

One of the features in SVUH is the direct transfer of patients in the ED to theatre for surgery. This is unique among trauma hospitals but allows efficient use of the surgical theatre without having to search for a ward bed prior to surgery,

Irish Hip Fracture Database National Report 2017

The Irish Hip Fracture Database National Report 2017 was launched today at the Irish Hip Fracture Meeting in the Royal College of Surgeons in Ireland. The purpose of the report is to highlight the importance of the standardisation and optimisation of hip fracture care and continual measurement and monitoring of data to improve outcomes for patients.

Speaking at the event, Dr Emer Ahern, Clinical Geriatric Lead for the Irish Hip Fracture Database said “Every day in Ireland, 10 people break their hips. Only 1 in 5 go home directly from hospital. There has been huge progress in hip fracture care in Ireland in the past 10 years and we will continue to use the data we collect to continually improve the care and outcomes for our patients’’