1. Better Together 2 Departments Focus To improve Hip Fracture Pathway to meet Msk Standards WHY? Original Pathway did not include all elements to reflect Gold Standard Msk Pathway Documentation missing/inadequate/not reflect best practice WHEN? By August, predict evidence of reaching Gold Standard WHAT? All Hip Fracture Patients entering Dr. Gray’s will receive Gold Standard Care Documented evidence/improved practice to meet National Guidelines WHO? Emergency Department and Orthopaedics, Ward 6

2. Emergency Department Hip Fracture Management and Audit tool With ED Team Leaders  Pathway documentation was discussed  Re-designed to reflect Gold Standard Care Missing Elements  No form of Cognitive Screening  No Record of Pressure area Checks Poor Documentation  ED Form would often be Blank!  Criteria sporadic/lacking

3. Exemplar Model Quality Improvement Approach  PDSA Templates Test Change  Continuing Local Audit & Msk Audit  Close liaison between departments

4. Completed Assessments by Element Trend for ED, Dr. Gray’s Hospital ( AMT4/4AT )

5. Ward 6 Robust Admission Procedure NHS Clinical Guidance - Assessment/Documentation Falls Assessment Nutritional Assessment Pressure Area Assessment Cognition Assessment did not exist  PDSA Templates Test Change  Local Audit & Continuing Msk Audit Nursing Initiative - apply AMT10 ALL patients over 65 years on admission to the Ward AMT4/4AT ?

6. Completed IN-Patient Assessments by Element Trend for Ward 6, Dr. Gray’s Hospital (AMT10)

7. What are we planning? Audit & Success? We really need to look at our Fasting For Theatre Times!