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Implementation of an electronic care pathway for hip fracture patients: a pilot before and after study

Talevski, J, Guerrero-Cedeño, V, Demontiero, O, Suriyaarachchi, P, Boersma, D, Vogrin, S, Brennan-Olsen, Sharon and Duque, G 2020, Implementation of an electronic care pathway for hip fracture patients: a pilot before and after study, BMC Musculoskeletal Disorders, vol. 21, pp. 1-7, doi: 10.1186/s12891-020-03834-w.

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Title Implementation of an electronic care pathway for hip fracture patients: a pilot before and after study
Author(s) Talevski, J
Guerrero-Cedeño, V
Demontiero, O
Suriyaarachchi, P
Boersma, D
Vogrin, S
Brennan-Olsen, SharonORCID iD for Brennan-Olsen, Sharon orcid.org/0000-0003-3269-5401
Duque, G
Journal name BMC Musculoskeletal Disorders
Volume number 21
Article ID 837
Start page 1
End page 7
Total pages 7
Publisher BMC
Place of publication London, Eng.
Publication date 2020
ISSN 1471-2474
1471-2474
Keyword(s) Care pathways
Hip fracture
Older adults
Orthogeriatric
Summary 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 e-pathway 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.
Language eng
DOI 10.1186/s12891-020-03834-w
Indigenous content off
Field of Research 1103 Clinical Sciences
HERDC Research category C1 Refereed article in a scholarly journal
Free to Read? Yes
Persistent URL http://hdl.handle.net/10536/DRO/DU:30148178

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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.