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Archives of Orthopaedic and Trauma Surgery

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01-08-2018 | Trauma Surgery

Recommended care received by geriatric hip fracture patients: where are we now and where are we heading?

Authors: Deborah Seys, An Sermon, Walter Sermeus, Massimiliano Panella, Luk Bruyneel, Paulo Boto, Kris Vanhaecht

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 8/2018

Abstract

Introduction

Despite the availability of clinical guidelines on the prevention and treatment of geriatric hip fractures, the percentage of recommended care received by patients is low. We conducted an importance–performance analysis for prioritizing interventions to improve the in-hospital management of these patients.

Materials and methods

A secondary data analysis was conducted on the in-hospital treatment of 540 geriatric hip fracture patients in 34 hospitals in Belgium, Italy, and Portugal. First, we assessed the level of expert consensus on the process indicators composing international guidelines on hip fracture treatment. Second, guideline adherence on in-hospital care was evaluated within and across hospitals. Third, an importance–performance analysis was conducted, linking expert consensus to guideline adherence.

Results

Level of expert consensus was high (above 75%) for 12 of 22 process indicators identified from the literature. There is large between and within hospital variation in guideline adherence for these indicators and for none of the 540 patients were all 22 process indicators adhered to. Importance–performance analysis demonstrated that three indicators that had a high level of expert consensus also had a high level of adherence (above 80%). Nine indicators, most of which have been previously linked to patient outcomes, had a high level of expert consensus but a consistently low level of adherence across hospitals and are identified as priority areas for improvement.

Conclusions

Guideline adherence for the treatment of geriatric hip fracture patients is remarkably suboptimal. Importance–performance analysis is a useful strategic approach to assist practitioners and healthcare managers to improve the quality of care.

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Title: Recommended care received by geriatric hip fracture patients: where are we now and where are we heading?
Authors: Deborah Seys
An Sermon
Walter Sermeus
Massimiliano Panella
Luk Bruyneel
Paulo Boto
Kris Vanhaecht
Publication date: 01-08-2018
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 8/2018
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-018-2939-4

At a glance: The STEP trials

Springer Medicine

Recommended care received by geriatric hip fracture patients: where are we now and where are we heading?

Abstract

Introduction

Materials and methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusions

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