Table 2.
Summary of selected findings
| Greater likelihood of discharge to original residence in hospitals with: | |
|---|---|
| Pre-op | More FTE for non-consultant grade ED doctors at the trust |
| Peri-op | Anaesthetic NHFD lead with role reflected in their job plan |
| More FTE for consultant anaesthetists at the trust | |
| Greater proportion of surgery which is NICE compliant | |
| Post-op | A Fracture Liaison Service is in place |
| Near-patient haemoglobin testing in routine use in recovery* | |
| 100% of patients receive an inpatient delirium assessment | |
| Governance | Consultant orthopaedic surgeon attends clinical governance meeting |
| Physiotherapist attends clinical governance meeting | |
| NHFD data regularly disseminated to hip fracture ward staff* | |
| Consultant anaesthetist attends clinical governance meeting | |
| Workload | More hours of orthogeriatric staff grade direct clinical care per week is provided |
| Greater likelihood of return to original residence at 120 days in hospitals with: | |
| Pre-op | Dedicated hip fracture ward to which patients can be admitted direct from ED |
| Treatment plan routinely discussed with the patient and NOK on admission | |
| Larger proportion of patients given a nerve block pre-op. | |
| Peri-op | Larger proportion of eligible patients receive a total hip replacement |
| Greater likelihood of good patient mobility outcomes in hospitals with: | |
| Pre-op | Pre-op. pain is routinely scored |
| More FTE for ED consultants at the trust | |
| Peri-op | 100% of patients assessed by an orthogeriatrician within 72 h of admission |
| Anaesthetic rota protocol includes consecutive trauma theatre days on call | |
| Larger proportion general anaesthetics accompanied by a nerve block | |
| Post-op | Near-patient haemoglobin testing in routine use in recovery* |
| Governance | Nursing lead attends clinical governance meeting |
| NHFD data regularly disseminated to hip fracture ward staff* | |
| Clinical governance meetings occur monthly | |
| Workload | More hours of orthogeriatric consultant direct clinical care per week is provided |
* indicates this organisational factor is important for more than one outcome
ED = Emergency Department, FTE = full time equivalent, NHFD = National Hip Fracture Database, NICE = National Institute for Clinical Excellence, NOK = next of kin, op = operative