Health outcomes after the implementation of multidisciplinary clinical guidelines for the care of hip fractures.
Atención continuada
Continued care
Fractura de cadera
Hip fracture
Internal Medicine
Medicina Interna
Orthogeriatrics
Ortogeriatría
Journal
Revista clinica espanola
ISSN: 2254-8874
Titre abrégé: Rev Clin Esp (Barc)
Pays: Spain
ID NLM: 101632437
Informations de publication
Date de publication:
Feb 2022
Feb 2022
Historique:
received:
29
12
2020
accepted:
15
04
2021
pubmed:
23
9
2021
medline:
12
3
2022
entrez:
22
9
2021
Statut:
ppublish
Résumé
This study aims to evaluate the impact of implementing multidisciplinary clinical guidelines in the process of caring for patients with hip fractures. This work is a pre- and post-intervention prospective study in the Orthogeriatrics Unit of a second-level hospital after implementing multidisciplinary clinical guidelines for hip fracture care. We analyzed patients' baseline characteristics and the variations observed in care provided and in outcome variables in the two periods studied (June 2015-May 2016 and June 2016-May 2017). The baseline characteristics of the population were similar in the pre-intervention period (n = 455) compared to the post-intervention period (n = 456). Patients' mean age was 84.8 ± 6.8 years and 70.8% were women. The implementation of the multidisciplinary clinical guidelines led to a reduction in the mean length of hospital stay (16.9 days vs. 15.6 days, p= .014); improved osteoporosis treatment prescribing (51.6% vs. 88%, p< .001); and reduced episodes of delirium (44% vs. 31.2%, p < .001), bronchospasm (18.3% vs. 12%, p = .019), heart failure (20% vs. 11.5%, p < .001), and COPD exacerbation (7.9% vs. 3.8%, P = .017). We observed an increase in pressure ulcers at discharge (2.9 vs. 9%, P < .001). There were no differences in the percentage of operations in less than 48 h (56% vs. 61.2% p = .64), hospital readmissions (6.9% vs. 5.9%, p = .51), or mortality (5.0% vs. 7.2%, p = .17). The implementation of multidisciplinary clinical guidelines improved aspects of the care process for patients with hip fracture.
Sections du résumé
BACKGROUND AND OBJECTIVES
OBJECTIVE
This study aims to evaluate the impact of implementing multidisciplinary clinical guidelines in the process of caring for patients with hip fractures.
MATERIALS AND METHODS
METHODS
This work is a pre- and post-intervention prospective study in the Orthogeriatrics Unit of a second-level hospital after implementing multidisciplinary clinical guidelines for hip fracture care. We analyzed patients' baseline characteristics and the variations observed in care provided and in outcome variables in the two periods studied (June 2015-May 2016 and June 2016-May 2017).
RESULTS
RESULTS
The baseline characteristics of the population were similar in the pre-intervention period (n = 455) compared to the post-intervention period (n = 456). Patients' mean age was 84.8 ± 6.8 years and 70.8% were women. The implementation of the multidisciplinary clinical guidelines led to a reduction in the mean length of hospital stay (16.9 days vs. 15.6 days, p= .014); improved osteoporosis treatment prescribing (51.6% vs. 88%, p< .001); and reduced episodes of delirium (44% vs. 31.2%, p < .001), bronchospasm (18.3% vs. 12%, p = .019), heart failure (20% vs. 11.5%, p < .001), and COPD exacerbation (7.9% vs. 3.8%, P = .017). We observed an increase in pressure ulcers at discharge (2.9 vs. 9%, P < .001). There were no differences in the percentage of operations in less than 48 h (56% vs. 61.2% p = .64), hospital readmissions (6.9% vs. 5.9%, p = .51), or mortality (5.0% vs. 7.2%, p = .17).
CONCLUSIONS
CONCLUSIONS
The implementation of multidisciplinary clinical guidelines improved aspects of the care process for patients with hip fracture.
Identifiants
pubmed: 34548255
pii: S2254-8874(21)00147-8
doi: 10.1016/j.rceng.2021.04.007
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
73-81Informations de copyright
Copyright © 2021 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.