Efficiency of the lausanne clinical pathway for proximal femoral fractures.

Details

Ressource 1Download: BIB_A737434FC709.P001.pdf (679.15 [Ko])
State: Public
Version: author
Serval ID
serval:BIB_A737434FC709
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Efficiency of the lausanne clinical pathway for proximal femoral fractures.
Journal
Frontiers in Surgery
Author(s)
Fleury N., Chevalley F., Rubli E., Coti P., Farron A., Jolles B.M.
ISSN
2296-875X (Electronic)
ISSN-L
2296-875X
Publication state
Published
Issued date
2015
Peer-reviewed
Oui
Volume
2
Number
2
Pages
5
Language
english
Notes
Publication types: Journal Article Publication Status: epublish
The authors would like to thank Ariane Seuret, Duong Hong Dung for their assistance in data collection and Estelle Lecureux for help with statistical analysis.
Abstract
Purpose/Introduction: The number of hip fractures is rising, due to increases in life expectancy. In such cases, patients are at risk from post-operative complications and subsequently the average length of hospitalization may be extended. In 2011, we established a clinical pathway (CP), a specific model of care for patient-care management, to improve the clinical and economic outcomes of proximal femoral fracture management in elderly patients. The goal was to evaluate the CP using clinical, process, and financial indicators.
METHODS: We included all surgical patients aged 65 and over, admitted to the emergency department with a fracture of the proximal femur following a fall. Assessment parameters included three performance indicators: clinical, process, and financial. The clinical indicators were the presence or absence of acute delirium on the third post-operative day, diagnosis of nosocomial pneumonia, and the number of patients fulfilling at least 75% of their nutritional requirements at the end of the hospitalization period. The process indicator was the time interval between arrival at the emergency department and surgery. The financial indicator was based on the number of days spent in hospital.
RESULTS: From 2011 to 2013, 669 patients were included in the CP. We observed that the average length of stay in hospital decreased as soon as the CP was implemented and stabilized afterwards. The goal of 90% of patients undergoing surgery within 48 h of arrival in the emergency department was surpassed in 2013 (93.1%). Furthermore, we observed an improvement in the clinical indicators.
CONCLUSION: The application of a CP allowed an improvement in the qualitative and quantitative efficiency of proximal femoral fracture management in elderly patients, in terms of clinical, process, and financial factors.
Pubmed
Open Access
Yes
Create date
16/01/2015 11:44
Last modification date
20/08/2019 15:12
Usage data