Cargando…
Efficiency of the Lausanne Clinical Pathway for Proximal Femoral Fractures
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...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2015
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4333714/ https://www.ncbi.nlm.nih.gov/pubmed/25745631 http://dx.doi.org/10.3389/fsurg.2015.00005 |
_version_ | 1782358089271345152 |
---|---|
author | Fleury, Nicole Chevalley, François Rubli, Eve Coti, Pauline Farron, Alain Jolles, Brigitte M. |
author_facet | Fleury, Nicole Chevalley, François Rubli, Eve Coti, Pauline Farron, Alain Jolles, Brigitte M. |
author_sort | Fleury, Nicole |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-4333714 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-43337142015-03-05 Efficiency of the Lausanne Clinical Pathway for Proximal Femoral Fractures Fleury, Nicole Chevalley, François Rubli, Eve Coti, Pauline Farron, Alain Jolles, Brigitte M. Front Surg Surgery 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. Frontiers Media S.A. 2015-02-19 /pmc/articles/PMC4333714/ /pubmed/25745631 http://dx.doi.org/10.3389/fsurg.2015.00005 Text en Copyright © 2015 Fleury, Chevalley, Rubli, Coti, Farron and Jolles. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Surgery Fleury, Nicole Chevalley, François Rubli, Eve Coti, Pauline Farron, Alain Jolles, Brigitte M. Efficiency of the Lausanne Clinical Pathway for Proximal Femoral Fractures |
title | Efficiency of the Lausanne Clinical Pathway for Proximal Femoral Fractures |
title_full | Efficiency of the Lausanne Clinical Pathway for Proximal Femoral Fractures |
title_fullStr | Efficiency of the Lausanne Clinical Pathway for Proximal Femoral Fractures |
title_full_unstemmed | Efficiency of the Lausanne Clinical Pathway for Proximal Femoral Fractures |
title_short | Efficiency of the Lausanne Clinical Pathway for Proximal Femoral Fractures |
title_sort | efficiency of the lausanne clinical pathway for proximal femoral fractures |
topic | Surgery |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4333714/ https://www.ncbi.nlm.nih.gov/pubmed/25745631 http://dx.doi.org/10.3389/fsurg.2015.00005 |
work_keys_str_mv | AT fleurynicole efficiencyofthelausanneclinicalpathwayforproximalfemoralfractures AT chevalleyfrancois efficiencyofthelausanneclinicalpathwayforproximalfemoralfractures AT rublieve efficiencyofthelausanneclinicalpathwayforproximalfemoralfractures AT cotipauline efficiencyofthelausanneclinicalpathwayforproximalfemoralfractures AT farronalain efficiencyofthelausanneclinicalpathwayforproximalfemoralfractures AT jollesbrigittem efficiencyofthelausanneclinicalpathwayforproximalfemoralfractures |