Posts

Indicators & Change Ideas

Are you looking to improve the issues facing today’s health care system?

 

Explore the quality indicators being tracked by health care organizations in Ontario through Quality Improvement Plans (QIPs) and change ideas to help improve them. Connect with others to share your experiences and ideas of your own.

INDICATORS & CHANGE IDEAS

  • 0
  • 91

Percentage of people who undergo hip fracture surgery within 48 hours of first arrival at any hospital

0 Comments

People with hip fracture requiring surgery should receive surgical intervention as soon as possible, within a maximum of 48 hours of their first presentation to hospital, regardless of whether they are subsequently transferred to another hospital for surgery. Increased time to surgery causes prolongation of pain and extended hospital stays and is associated with increased morbidity and mortality.

Each year, about 12,000 people in Ontario aged 50 years and older experience a hip fracture. In FY 2022/23, one-quarter (25%) of people with hip fracture waited longer than the recommended 48 hours for surgery. Most people who had hip fracture surgery (85%) were admitted through the ED. However, those admitted through the ED had longer wait times than those admitted directly as an inpatient, with median wait times of 33 hours and 21 hours, respectively.

Key Resources

Change Ideas

Standardize and streamline the hip fracture care pathway

Prioritize surgery for hip fracture patients

  • Prioritize hip fracture cases as B cases and escalate urgency as elapsed time approaches 42 hours
  • Dedicate blocks of operating room time each day for emergency orthopaedic cases
  • National Hip Fracture Toolkit, see Operating Room Priority Management
  • Hip Fracture Quality Standard, see Quality Statement 2: Surgery Within 48 Hours

Review Hip Fracture Data Regularly

  • Initiate regular interprofessional reviews of data on wait time to surgery for people with hip fracture to identify organizational opportunities for improvement. Potential data sources include:
    Ontario Health’s Hip Fracture eReport
    - For hospitals participating in ONSQIN: Collect targeted hip fracture procedure data via NSQIP to track postoperative outcomes and performance. Please contact ONSQIN@ontariohealth.ca for assistance
    Power BI organizational dashboard

Build capacity to develop an interdisciplinary approach to hip fracture care quality improvement


Percentage of people who undergo hip fracture surgery within 48 hours of first arrival at any hospital

0 Comments

People with hip fracture requiring surgery should receive surgical intervention as soon as possible, within a maximum of 48 hours of their first presentation to hospital, regardless of whether they are subsequently transferred to another hospital for surgery. Increased time to surgery causes prolongation of pain and extended hospital stays and is associated with increased morbidity and mortality.

Each year, about 12,000 people in Ontario aged 50 years and older experience a hip fracture. In FY 2022/23, one-quarter (25%) of people with hip fracture waited longer than the recommended 48 hours for surgery. Most people who had hip fracture surgery (85%) were admitted through the ED. However, those admitted through the ED had longer wait times than those admitted directly as an inpatient, with median wait times of 33 hours and 21 hours, respectively.

Key Resources

Change Ideas

Standardize and streamline the hip fracture care pathway

Prioritize surgery for hip fracture patients

  • Prioritize hip fracture cases as B cases and escalate urgency as elapsed time approaches 42 hours
  • Dedicate blocks of operating room time each day for emergency orthopaedic cases
  • National Hip Fracture Toolkit, see Operating Room Priority Management
  • Hip Fracture Quality Standard, see Quality Statement 2: Surgery Within 48 Hours

Review Hip Fracture Data Regularly

  • Initiate regular interprofessional reviews of data on wait time to surgery for people with hip fracture to identify organizational opportunities for improvement. Potential data sources include:
    Ontario Health’s Hip Fracture eReport
    - For hospitals participating in ONSQIN: Collect targeted hip fracture procedure data via NSQIP to track postoperative outcomes and performance. Please contact ONSQIN@ontariohealth.ca for assistance
    Power BI organizational dashboard

Build capacity to develop an interdisciplinary approach to hip fracture care quality improvement


Aaron Miller True