Fractured Neck of Femur - Anaesthetic Trial
A week-long trial at Pinderfields Hospital introduced a new way of working to treat patients with a fractured Neck of Femur (NoF) and the results were fantastic.
As a Trust we were failing to hit the Best Practice Tariff (BPT) for treating hip fractures because surgery was not being performed on patients within 36 hours of their admission.
To tackle this we trialled a different way of working for a week.
The same consultant anaesthetist covered all the cases in one of the trauma theatres for the whole week, with lists being scheduled as all day lists. A registrar was also present for most of the week to assist the consultant, allowing them to attend the morning trauma meeting – ensuring NoF patients were prioritised - without affecting the prompt start of surgery each day. The consultant also had an increased presence on the elderly care ward, reviewing patients post operatively and working closely with the ortho-geriatric team.
The throughput of trauma cases during the week was high, and 10 elderly patients were admitted with fractured NoF, but the results speak for themselves.
During the trial the average time to surgery from admission was 19 hours, there were no early deaths and some patients were discharged home within five days of admission. We saw greater theatre efficiencies and a standardisation of anaesthetic care, all the teams involved worked together extremely well, staff morale was high, and we also achieved our BPT.
Having a senior clinician providing continuity of care for the patients helped to ensure they were not delayed for inappropriate reasons. This single point of contact also facilitated communication within the Trust, as junior orthopaedic doctors knew who to contact when a NoF patient was admitted to A & E, enabling the consultant to provide early assessment and advice.
Patrick O’Connor was the consultant anaesthetist involved in the trial, he said: “I want to thank everyone who was involved in the trial, particularly the staff on Ward 42 and the theatre team. It has illustrated that by adopting different ways of working we can make improvements, which are of benefit to everyone. During the trial I felt as though we were making a positive difference to patient care and this was very rewarding.”
We are planning to introduce this way of working on a permanent basis from early in 2018 and hopefully this will see these benefits sustained for the long-term.