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Brigham Fracture Intervention Team Initiatives for Hospital Patients with Hip Fractures: A Paradigm Shift

We designed, implemented, and revised the Brigham Fracture Intervention Team (B-FIT) initiatives to improve in-hospital care of fracture (Fx) patients. Effectiveness was evaluated for 181 medical records of 4 cohorts in four successive years of consecutive patients who were admitted with a fragility...

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Autores principales: Glowacki, Julie, Harris, Mitchel B., Simon, Josef, Wright, John, Kolatkar, Nikheel S., Thornhill, Thomas S., LeBoff, Meryl S.
Formato: Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2778190/
https://www.ncbi.nlm.nih.gov/pubmed/20011097
http://dx.doi.org/10.1155/2010/590751
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author Glowacki, Julie
Harris, Mitchel B.
Simon, Josef
Wright, John
Kolatkar, Nikheel S.
Thornhill, Thomas S.
LeBoff, Meryl S.
author_facet Glowacki, Julie
Harris, Mitchel B.
Simon, Josef
Wright, John
Kolatkar, Nikheel S.
Thornhill, Thomas S.
LeBoff, Meryl S.
author_sort Glowacki, Julie
collection PubMed
description We designed, implemented, and revised the Brigham Fracture Intervention Team (B-FIT) initiatives to improve in-hospital care of fracture (Fx) patients. Effectiveness was evaluated for 181 medical records of 4 cohorts in four successive years of consecutive patients who were admitted with a fragility hip Fx. The Discharge Initiative (DI) (computer-based) includes 1200 mg calcium and 1000 IU vitamin D(3) daily. The Admission Initiative (AI) was introduced one year later with reminders for serum 25OHD measurement, initiation of daily calcium (1200 mg) and vitamin D (800 IU), and an order for Endocrinology consultation, with an amendment for a computer-assisted reminder and a dose of D(2) (50 000 IU). Initially, the computer-based DI was more effective (67%) than the surgeon-driven AI (33%, P < .001). After introduction of a computer-assisted reminder, AI effectiveness increased to 68%. The marked prevalence of vitamin D insufficiency reaffirms the importance of incorporating vitamin D recommendations in Fx care pathways.
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spelling pubmed-27781902009-12-10 Brigham Fracture Intervention Team Initiatives for Hospital Patients with Hip Fractures: A Paradigm Shift Glowacki, Julie Harris, Mitchel B. Simon, Josef Wright, John Kolatkar, Nikheel S. Thornhill, Thomas S. LeBoff, Meryl S. Int J Endocrinol Research Article We designed, implemented, and revised the Brigham Fracture Intervention Team (B-FIT) initiatives to improve in-hospital care of fracture (Fx) patients. Effectiveness was evaluated for 181 medical records of 4 cohorts in four successive years of consecutive patients who were admitted with a fragility hip Fx. The Discharge Initiative (DI) (computer-based) includes 1200 mg calcium and 1000 IU vitamin D(3) daily. The Admission Initiative (AI) was introduced one year later with reminders for serum 25OHD measurement, initiation of daily calcium (1200 mg) and vitamin D (800 IU), and an order for Endocrinology consultation, with an amendment for a computer-assisted reminder and a dose of D(2) (50 000 IU). Initially, the computer-based DI was more effective (67%) than the surgeon-driven AI (33%, P < .001). After introduction of a computer-assisted reminder, AI effectiveness increased to 68%. The marked prevalence of vitamin D insufficiency reaffirms the importance of incorporating vitamin D recommendations in Fx care pathways. Hindawi Publishing Corporation 2010 2009-08-26 /pmc/articles/PMC2778190/ /pubmed/20011097 http://dx.doi.org/10.1155/2010/590751 Text en Copyright © 2010 Julie Glowacki et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Glowacki, Julie
Harris, Mitchel B.
Simon, Josef
Wright, John
Kolatkar, Nikheel S.
Thornhill, Thomas S.
LeBoff, Meryl S.
Brigham Fracture Intervention Team Initiatives for Hospital Patients with Hip Fractures: A Paradigm Shift
title Brigham Fracture Intervention Team Initiatives for Hospital Patients with Hip Fractures: A Paradigm Shift
title_full Brigham Fracture Intervention Team Initiatives for Hospital Patients with Hip Fractures: A Paradigm Shift
title_fullStr Brigham Fracture Intervention Team Initiatives for Hospital Patients with Hip Fractures: A Paradigm Shift
title_full_unstemmed Brigham Fracture Intervention Team Initiatives for Hospital Patients with Hip Fractures: A Paradigm Shift
title_short Brigham Fracture Intervention Team Initiatives for Hospital Patients with Hip Fractures: A Paradigm Shift
title_sort brigham fracture intervention team initiatives for hospital patients with hip fractures: a paradigm shift
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2778190/
https://www.ncbi.nlm.nih.gov/pubmed/20011097
http://dx.doi.org/10.1155/2010/590751
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