REFLECTIONS ON HIP FRACTURE AUDIT Oh shit another boring audit talk

HIP # AUDIT Assesses whole process of # Care –A&E process –Admission process –Surgical Assessment and processing –Anaesthetic care and processing –Surgery –Post op and Rehab –Complications

HIP # SAHFE DATABASE 1997 Start Audit Introduce change 1998 Measure change 1999 Fine tune changes 2000 and on Audit service

The Aim - Improve Quality of Care Morbitity Mortality In Patient Stay Dependance The workers Cost Inefficiency Bed Occupancy The Managers

HIP # AUDIT IS CONTINUING AUDIT JUST BORING NUMBER CRUNCHING PROCESS ?

BENEFITS Basis for increased funding of # service

COOKING PHILOSOPHY INGREDIENTS Patients Audit Nurse Resources Interested Clinicians Use the SAHFE Cookboook OR Adlib??????

REFLECTIONS ON THE RECIPES HIP # AUDIT = FOLLOW-UP Process of Audit Data collection led to patient contact and a Clinical Care Opportunity. SO What else can be done with this?

RECIPE No 1 Audit nurse follow up of all hip# Routine # clinic review replaced by Audit nurse contact at 4 and 12 months >400 return patient appts p.a. in # Clinic Replaced by 30 pat returns p.a.

RECIPE No 2 Audit nurse arranging for physioRx Identification of need may be only for PhysioRx Ability for direct referral by Audit nurse

RECIPE No 3 Audit nurse actions clinic review Consultant review of all clinic returns agreed Point of contact for patients and GPs circumventing clinic referral letters and needless waits

RECIPE No 4 Physiotherapy falls prevention and education Contact used to get greatest benefit Multidisciplinary use of Data

RECIPE No 5 Osteoporosis Education Targeting Osteoporosis Interventions

RECIPE No 6 QUALITY ISSUES AND QUALITY ENHANCEMENT Written Notes DVT Prophylaxis Anaesthetic charts CLINICAL INCIDENT REPORTING

UNEXPECTED DISHES Telephone review became a clinical tool - someone cared Encouraged multi-disciplinary communication Saved money! Clinical governance tool –teaching aid

WHY HAS THE AUDIT BEEN SUCH A LOCAL SUCCESS? Local ownership Proactive clinician On site analysis Reaction to ALL data Multi-disciplinary participation Development and closed the loop

DESSERTS AUDIT SHOULD BE SEEN AS A CLINICAL CARE TOOL CLINICIANS MUST BE INVOLVED TO MAKE IT WORK 12 MONTH FOLLOW-UP ESSENTIAL

THANKYOU ?