Enhanced recovery after surgery: An opportunity to improve fractured neck of femur management
Authors: Wainwright, T.W., Immins, T. and Middleton, R.G.
Journal: Annals of the Royal College of Surgeons of England
Volume: 98
Issue: 7
Pages: 500-506
ISSN: 0035-8843
DOI: 10.1308/rcsann.2016.0196
Abstract:INTRODUCTION Approximately 67,000 hip fractures occurred in England, Wales and Northern Ireland in 2014, and annual hospital costs for fracture are around £1.1 billion. We review the potential scope for improving length of stay (LOS). METHODS Hospital Episode Statistics data on non-elective admissions to 137 hospital trusts between November 2013 and October 2014 with a primary diagnosis of fractured neck of femur were analysed. The primary outcome was superspell LOS, which is the total LOS for all related spells for a single patient during an episode of care. Secondary outcomes were discharge to home, readmission at 28 days and in-hospital mortality. RESULTS The mean observed LOS was 22.1±3.8 days (range 12.3-33.7 days). The range for case mix-adjusted expected LOS was 21.5-24.4 days. On average, 6.7±1.5% (range 3.6%-10.9%) of patients died while in hospital, at a relative risk of in-hospital mortality of 28.2-182.9. A mean of 12.3±3.2% (range 3.9% to 23.0%) of patients were readmitted at 28 days, at a relative relative risk of 34.8-203.2. CONCLUSIONS The wide range of observed LOS in our study is unlikely to be due to the case mix, as the case mix-adjusted range of LOS is less than 3 days, but rather due to local processes and pathways. There is therefore considerable scope for quality and efficiency of care improvements in our hospitals. We propose this could be best achieved if clinicians experienced in enhanced recovery focused on FNOF pathways.
https://eprints.bournemouth.ac.uk/24074/
Source: Scopus
Enhanced recovery after surgery: An opportunity to improve fractured neck of femur management.
Authors: Wainwright, T.W., Immins, T. and Middleton, R.G.
Journal: Ann R Coll Surg Engl
Volume: 98
Issue: 7
Pages: 500-506
eISSN: 1478-7083
DOI: 10.1308/rcsann.2016.0196
Abstract:Introduction Approximately 67,000 hip fractures occurred in England, Wales and Northern Ireland in 2014, and annual hospital costs for fracture are around £1.1 billion. We review the potential scope for improving length of stay (LOS). Methods Hospital Episode Statistics data on non-elective admissions to 137 hospital trusts between November 2013 and October 2015 with a primary diagnosis of fractured neck of femur were analysed. The primary outcome was superspell LOS, which is the total LOS for all related spells for a single patient during an episode of care. Secondary outcomes were discharge to home, readmission at 28 days and in-hospital mortality. Results The mean observed LOS was 22.1±3.8 days (range 12.3-33.7 days). The range for case mix-adjusted expected LOS was 21.5-24.4 days. On average, 6.7±1.5% (range 3.6%-10.9%) of patients died while in hospital, at a relative risk of in-hospital mortality of 28.2-182.9. A mean of 12.3±3.2% (range 3.9% to 23.0%) of patients were readmitted at 28 days, at a relative relative risk of 34.8-203.2. Conclusions The wide range of observed LOS in our study is unlikely to be due to the case mix, as the case mix-adjusted range of LOS is less than 3 days, but rather due to local processes and pathways. There is therefore considerable scope for quality and efficiency of care improvements in our hospitals. We propose this could be best achieved if clinicians experienced in enhanced recovery focused on FNOF pathways.
https://eprints.bournemouth.ac.uk/24074/
Source: PubMed
Enhanced recovery after surgery: An opportunity to improve fractured neck of femur management
Authors: Wainwright, T.W., Immins, T. and Middleton, R.G.
Journal: ANNALS OF THE ROYAL COLLEGE OF SURGEONS OF ENGLAND
Volume: 98
Issue: 7
Pages: 500-506
eISSN: 1478-7083
ISSN: 0035-8843
DOI: 10.1308/rcsann.2016.0196
https://eprints.bournemouth.ac.uk/24074/
Source: Web of Science (Lite)
Enhanced recovery after surgery: An opportunity to improve fractured neck of femur management
Authors: Wainwright, T., Immins, K. and Middleton, R.G.
Journal: Annals of the Royal College of Surgeons of England
Publisher: Royal College of Surgeons of England
ISSN: 1478-7083
DOI: 10.1308/rcsann.2016.0196
Abstract:ABSTRACT INTRODUCTION Approximately 67,000 hip fractures occurred in England, Wales and Northern Ireland in 2014, and annual hospital costs for fracture are around £1.1 billion. We review the potential scope for improving length of stay (LOS).
METHODS Hospital Episode Statistics data on non-elective admissions to 137 hospital trusts between November 2013 and October 2014 with a primary diagnosis of fractured neck of femur were analysed. The primary outcome was superspell LOS, which is the total LOS for all related spells for a single patient during an episode of care. Secondary outcomes were discharge to home, readmission at 28 days and in-hospital mortality.
RESULTS The mean observed LOS was 22.1±3.8 days (range 12.3–33.7 days). The range for case mix-adjusted expected LOS was 21.5–24.4 days. On average, 6.7±1.5% (range 3.6%–10.9%) of patients died while in hospital, at a relative risk of in-hospital mortality of 28.2–182.9. A mean of 12.3±3.2% (range 3.9% to 23.0%) of patients were readmitted at 28 days, at a relative relative risk of 34.8–203.2.
CONCLUSIONS The wide range of observed LOS in our study is unlikely to be due to the case mix, as the case mix-adjusted range of LOS is less than 3 days, but rather due to local processes and pathways. There is therefore considerable scope for quality and efficiency of care improvements in our hospitals. We propose this could be best achieved if clinicians experienced in enhanced recovery focused on FNOF pathways.
https://eprints.bournemouth.ac.uk/24074/
Source: Manual
Enhanced recovery after surgery: An opportunity to improve fractured neck of femur management.
Authors: Wainwright, T.W., Immins, T. and Middleton, R.G.
Journal: Annals of the Royal College of Surgeons of England
Volume: 98
Issue: 7
Pages: 500-506
eISSN: 1478-7083
ISSN: 0035-8843
DOI: 10.1308/rcsann.2016.0196
Abstract:Introduction Approximately 67,000 hip fractures occurred in England, Wales and Northern Ireland in 2014, and annual hospital costs for fracture are around £1.1 billion. We review the potential scope for improving length of stay (LOS). Methods Hospital Episode Statistics data on non-elective admissions to 137 hospital trusts between November 2013 and October 2015 with a primary diagnosis of fractured neck of femur were analysed. The primary outcome was superspell LOS, which is the total LOS for all related spells for a single patient during an episode of care. Secondary outcomes were discharge to home, readmission at 28 days and in-hospital mortality. Results The mean observed LOS was 22.1±3.8 days (range 12.3-33.7 days). The range for case mix-adjusted expected LOS was 21.5-24.4 days. On average, 6.7±1.5% (range 3.6%-10.9%) of patients died while in hospital, at a relative risk of in-hospital mortality of 28.2-182.9. A mean of 12.3±3.2% (range 3.9% to 23.0%) of patients were readmitted at 28 days, at a relative relative risk of 34.8-203.2. Conclusions The wide range of observed LOS in our study is unlikely to be due to the case mix, as the case mix-adjusted range of LOS is less than 3 days, but rather due to local processes and pathways. There is therefore considerable scope for quality and efficiency of care improvements in our hospitals. We propose this could be best achieved if clinicians experienced in enhanced recovery focused on FNOF pathways.
https://eprints.bournemouth.ac.uk/24074/
Source: Europe PubMed Central
Enhanced recovery after surgery: An opportunity to improve fractured neck of femur management
Authors: Wainwright, T., Immins, T. and Middleton, R.
Journal: Annals of The Royal College of Surgeons of England
Volume: 98
Issue: 7
Pages: 500-506
ISSN: 1478-7083
Abstract:ABSTRACT INTRODUCTION Approximately 67,000 hip fractures occurred in England, Wales and Northern Ireland in 2014, and annual hospital costs for fracture are around £1.1 billion. We review the potential scope for improving length of stay (LOS). METHODS Hospital Episode Statistics data on non-elective admissions to 137 hospital trusts between November 2013 and October 2014 with a primary diagnosis of fractured neck of femur were analysed. The primary outcome was superspell LOS, which is the total LOS for all related spells for a single patient during an episode of care. Secondary outcomes were discharge to home, readmission at 28 days and in-hospital mortality. RESULTS The mean observed LOS was 22.1±3.8 days (range 12.3–33.7 days). The range for case mix-adjusted expected LOS was 21.5–24.4 days. On average, 6.7±1.5% (range 3.6%–10.9%) of patients died while in hospital, at a relative risk of in-hospital mortality of 28.2–182.9. A mean of 12.3±3.2% (range 3.9% to 23.0%) of patients were readmitted at 28 days, at a relative relative risk of 34.8–203.2. CONCLUSIONS The wide range of observed LOS in our study is unlikely to be due to the case mix, as the case mix-adjusted range of LOS is less than 3 days, but rather due to local processes and pathways. There is therefore considerable scope for quality and efficiency of care improvements in our hospitals. We propose this could be best achieved if clinicians experienced in enhanced recovery focused on FNOF pathways.
https://eprints.bournemouth.ac.uk/24074/
Source: BURO EPrints