AB250. Improving clinical outcomes of hip fracture management in Sligo University Hospital, raising the IHFD standards

Background: Fragility hip fractures pose a significant global challenge both to healthcare systems and to patients themselves. The Irish Hip Fracture database (IHFD) was initiated in 2012 to improve the quality of hip fracture care by providing insight into 6 standard of care provided to people over the age of 60 admitted to Irish hospitals with hip fractures. In 2013 Sligo University Hospital (SUH), began collecting data as part of the IHFD. This data’s primary outcome is to benchmark current performance against the IHFD recommendations, identify areas in need of improvement, compare against previous performance and to compare our performance against other hospitals involved in the audit.

Methods: This is a single centre retrospective cohort study assessing the outcomes of the IHFD in SUH across 5 years. All hip fractures admitted to SUH from 2013 to 2017 were reviewed by our hip fracture co-ordinator and data across all the 6 standards was collected. We reviewed this data retrospectively to assess if the standard of care provided was improved by nature of auditing alone given very little departmental, infrastructure or policy changes had been made during the auditing period.

Results: Over the last five years (2013–2017 inclusive), SUH have achieved continuous improvement in compliance among each of the 6 guidelines. SUH also compares very well with other hospitals involved in the audit across Ireland and has become a national leader in some standards across the years (2017 Irish hip fracture standards (IHFS) 1=(46%), IHFS 2=(77%), IHFS 3=(2%). There is some variance year on year within the standard achievements but all standards improved over the 5 years with improvements of between 25% to 1,200% seen in the data with very little infrastructure or policy changes.

Conclusions: This study has proved that continuous auditing of standards improves the quality of care provided to patients and the overall clinical outcome. Auditing not only highlights areas in which care provision should be improved but also encourages staff participation in improving patient standard of care which leads to improved outcomes overall.

Keywords: Irish hip fracture database standards; Sligo University Hospital; hip fractures; Irish hip fracture standards; patient care quality improvement