Implementation of an electronic care pathway for hip fracture patients: a pilot before and after study
- PDF / 532,345 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 98 Downloads / 193 Views
(2020) 21:837
RESEARCH ARTICLE
Open Access
Implementation of an electronic care pathway for hip fracture patients: a pilot before and after study Jason Talevski1,2* , Viviana Guerrero-Cedeño1,2, Oddom Demontiero3, Pushpa Suriyaarachchi3, Derek Boersma3, Sara Vogrin1,2, Sharon Brennan-Olsen1,2 and Gustavo Duque1,2,3
Abstract Background: Care pathways are generally paper-based and can cause communication failures between multidisciplinary teams, potentially compromising the safety of the patient. Computerized care pathways may facilitate better communication between clinical teams. This study aimed to investigate whether an electronic care pathway (e-pathway) reduces delays in surgery and hospital length of stay compared to a traditional paper-based care pathway (control) in hip fracture patients. Methods: A single-centre evaluation with a retrospective control group was conducted in the Orthogeriatric Ward, Nepean Hospital, New South Wales, Australia. We enrolled patients aged > 65 years that were hospitalized for a hip fracture in 2008 (control group) and 2012 (e-pathway group). The e-pathway provided the essential steps in the care of patients with hip fracture, including examinations and treatment to be carried out. Main outcome measures were delay in surgery and hospital length of stay; secondary outcomes were in-hospital mortality and discharge location. Results: A total of 181 patients were enrolled in the study (129 control; 54 e-pathway group). There was a significant reduction in delay to surgery in the e-pathway group compared to control group in unadjusted (OR = 0.19; CI 0.09–0.39; p < 0.001) and adjusted (OR = 0.22; CI 0.10–0.49; p < 0.001) models. There were no significant differences between groups for length of stay (median 11 vs 12 days; p = 0.567), in-hospital mortality (1 vs 7 participants; p = 0.206) or discharge location (p = 0.206). Conclusions: This pilot study suggests that, compared to a paper-based care pathway, implementation of an epathway for hip fracture patients results in a reduction in total number of delays to surgery, but not hospital length of stay. Further evaluation is warranted using a larger cohort investigating both clinical and patient-reported outcome measures. Keywords: Care pathways, Older adults, Orthogeriatric, Hip fracture
* Correspondence: [email protected] 1 Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, Melbourne, VIC, Australia 2 Department of Medicine-Western Health, The University of Melbourne, Melbourne, VIC, Australia Full list of author information is available at the end of the article
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or ot
Data Loading...
