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Implementing an advanced physiotherapy outpatient triaging service as a model for improvement for patients recently discharged following surgical intervention for hip fracture

Every year there are 1.3 million hip fractures globally; this is expected to rise to 6 million by 2050. Estimates of global cost is 1.75 million disability adjusted life years, and in established market economies, costs associated with hip fracture represent 1.4% of the total healthcare burden. New...

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Autores principales: Ferrier, Rebecca, Bell, Jack, Sheehan, Katie J, Sutton, Emma
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10565325/
https://www.ncbi.nlm.nih.gov/pubmed/37783517
http://dx.doi.org/10.1136/bmjoq-2023-002348
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author Ferrier, Rebecca
Bell, Jack
Sheehan, Katie J
Sutton, Emma
author_facet Ferrier, Rebecca
Bell, Jack
Sheehan, Katie J
Sutton, Emma
author_sort Ferrier, Rebecca
collection PubMed
description Every year there are 1.3 million hip fractures globally; this is expected to rise to 6 million by 2050. Estimates of global cost is 1.75 million disability adjusted life years, and in established market economies, costs associated with hip fracture represent 1.4% of the total healthcare burden. New models of care will be required to meet this demand. Advance physiotherapy roles in elective arthroplasty across global settings have demonstrated benefit in safely reducing time burden on surgical teams and healthcare costs. The utility of similar roles in the care of hip fracture is unclear. This quality initiative (2020–2023) aimed to implement and evaluate a new model of care substituting a surgical registrar with an advanced physiotherapist in a post-discharge hip fracture clinic. Across many nonlinear, action/reflection cycles, a multi-disciplinary team engaged to operationalize key implementation strategies, mapped to the Expert Recommendations for Implementing Change (ERIC) project. Across the reporting period, 346 patients were seen by an advanced physiotherapist. Eighty-one patients seen by an advanced physiotherapist required informal discussion with the consultant surgeon. Fifteen patients required a formal consultant review. There were no patient complaints, critical incidents or other unintended consequences. The net surgical time realized over the three years was 110 hours.
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spelling pubmed-105653252023-10-12 Implementing an advanced physiotherapy outpatient triaging service as a model for improvement for patients recently discharged following surgical intervention for hip fracture Ferrier, Rebecca Bell, Jack Sheehan, Katie J Sutton, Emma BMJ Open Qual Short Report Every year there are 1.3 million hip fractures globally; this is expected to rise to 6 million by 2050. Estimates of global cost is 1.75 million disability adjusted life years, and in established market economies, costs associated with hip fracture represent 1.4% of the total healthcare burden. New models of care will be required to meet this demand. Advance physiotherapy roles in elective arthroplasty across global settings have demonstrated benefit in safely reducing time burden on surgical teams and healthcare costs. The utility of similar roles in the care of hip fracture is unclear. This quality initiative (2020–2023) aimed to implement and evaluate a new model of care substituting a surgical registrar with an advanced physiotherapist in a post-discharge hip fracture clinic. Across many nonlinear, action/reflection cycles, a multi-disciplinary team engaged to operationalize key implementation strategies, mapped to the Expert Recommendations for Implementing Change (ERIC) project. Across the reporting period, 346 patients were seen by an advanced physiotherapist. Eighty-one patients seen by an advanced physiotherapist required informal discussion with the consultant surgeon. Fifteen patients required a formal consultant review. There were no patient complaints, critical incidents or other unintended consequences. The net surgical time realized over the three years was 110 hours. BMJ Publishing Group 2023-10-02 /pmc/articles/PMC10565325/ /pubmed/37783517 http://dx.doi.org/10.1136/bmjoq-2023-002348 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Short Report
Ferrier, Rebecca
Bell, Jack
Sheehan, Katie J
Sutton, Emma
Implementing an advanced physiotherapy outpatient triaging service as a model for improvement for patients recently discharged following surgical intervention for hip fracture
title Implementing an advanced physiotherapy outpatient triaging service as a model for improvement for patients recently discharged following surgical intervention for hip fracture
title_full Implementing an advanced physiotherapy outpatient triaging service as a model for improvement for patients recently discharged following surgical intervention for hip fracture
title_fullStr Implementing an advanced physiotherapy outpatient triaging service as a model for improvement for patients recently discharged following surgical intervention for hip fracture
title_full_unstemmed Implementing an advanced physiotherapy outpatient triaging service as a model for improvement for patients recently discharged following surgical intervention for hip fracture
title_short Implementing an advanced physiotherapy outpatient triaging service as a model for improvement for patients recently discharged following surgical intervention for hip fracture
title_sort implementing an advanced physiotherapy outpatient triaging service as a model for improvement for patients recently discharged following surgical intervention for hip fracture
topic Short Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10565325/
https://www.ncbi.nlm.nih.gov/pubmed/37783517
http://dx.doi.org/10.1136/bmjoq-2023-002348
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