Irish Hip Fracture Database National Report 2015

The IHFD is a clinically led, web-based audit which measures the care and outcomes of patients with hip fractures. Hip fracture care takes the patient through a complex clinical pathway involving a wide range of specialties. It is an ideal marker condition for the care of older patients in our acute hospitals and also tells us how well the trauma service is functioning. Hip fractures are an ideal condition to audit for the following reasons:• Commoncondition• Clearlydefineddiagnosis• Good evidence base for care and prevention• Care is complex and costly• Care, outcomes and costs vary• Numbers rising• High morbidity, mortality and loss of independence• 3,591 hip fractures in Ireland in 2015 (aged 60 years and over anddueto injury)This third IHFD report details 2,962 hip fracture cases in patients aged 60 years and over, discharged by 16 hospitals in 2015, which accounts for 81% of all hip fracture cases nationally.Nationally, the Model of Care for Trauma and Orthopaedic surgery2 declared the IHFD an integral part of driving clinical and organisational improvements in quality and effectiveness of care after a hip fracture. Measurement of hip fracture outcome is essential and should be recorded by all hospitals as part of a national hip fracture database.The National Healthcare Quality Report system second Annual Report3, published by the Department of Health details, key performance indicators about a number of conditions. The Hse Key Performance Indicator (KPI) for hip fracture surgery reports on the percentage of emergency hip fracture surgeries with the principal procedure carried out on days 0, 1 or 2 of the stay with a specified target of 95%. There can be many reasons for delays in performing hip fracture surgery, for example, the patient being too sick for surgery, but it can also be due to avoidable administrative reasons. Therefore, an indicator on time to hip fracture surgery is used internationally as a measure of quality.International evidence has shown us that the synergy of care standards, audit and feedback, drive measurable improvements in hip fracture outcomes for patients.In the IHFD we base our audit on six standards of care, as published by the british Orthopaedic Association and british geriatric society, in the ”blue book”; “The Care of Patients With Fragility Fracture”