The positive impact of a quality improvement collaborative on process indicators for geriatric hip fracture care

IF 3.1 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Archives of Osteoporosis Pub Date : 2025-02-12 DOI:10.1007/s11657-025-01504-9

Ellen Coeckelberghs, Deborah Seys, Charlotte Lens, Kris Vanhaecht, Fien Claessens, Caroline Weltens, Dirk De Ridder, Eline Depuydt, Wim De Weerdt, Thierry De Baets, Jessy Eysackers, Stijn Hermans, Michiel Herteleer, Geert Leirs, Sofie Lynen, Frederik Matthys, Ben Molenaers, Alexander Mulliez, Christophe Pattyn, Jan Somers, Mike Tengrootenhuysen, Maxence Vanderkerckhove, Marleen Van Esbroeck, Kyri Van Hecke, Eline Van Hove, Stefaan Nijs, An Sermon

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引用次数: 0

Abstract

Summary

Adherence to guidelines for geriatric patients with a hip fracture is challenging. With this study, adherence to important quality indicators in geriatric hip fracture care was improved. A quality improvement collaborative including benchmarking and knowledge sharing showed to be effective in improving quality of care.

Background

Adherence to guidelines for geriatric patients with an osteoporotic hip fracture is challenging. Therefore, the aim of this study was to improve the adherence to quality indicators (QIs) for these patients using benchmarking and knowledge sharing.

Method

A prospective multicenter study was initiated throughout 19 hospitals in Flanders, Belgium. Adherence to 23 QIs was measured. Two retrospective audits (based on patient record analyses) were conducted in 2018–2019 (measurement period (MP) 1) and 2021 (MP 2). Between both audits, anonymous benchmarking was provided to the participating centers and three educative sessions on specific topics were performed.

Results

A total of 1044 patients were included in the study. At MP 1, QIs showing the lowest adherence rates were the administration of nerve blocks, steroids, and tranexamic acid, applied in only 8.0%, 9.7% and 22.2% of the patients, respectively. At MP 2, these adherence rates significantly improved up to 25.4%, 26.4% and 30.7%, respectively (p < 0.001). The indication of the start of discharge planning also significantly improved between both periods (89.3% in MP 1 vs. 93.7% in MP 2, p = 0.043), while the avoidance of intra-operative hypotension was less well realized (56.2% in MP 1 vs. 52% in MP2, p = 0.026). Overall adherence significantly increased from 61.7 to 64.5% (p < 0.001). Delirium was significantly reduced (from 22.1% in MP 1 to 17.4% in MP 2, p = 0.030).

Conclusion

Benchmarking in combination with a peer-reviewed and knowledge sharing intervention increases the adherence to quality indicators for patients with a geriatric hip fracture.

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质量改进协作对老年髋部骨折护理过程指标的积极影响

对于老年髋部骨折患者，遵守指南是一项挑战。通过这项研究，对老年髋部骨折护理重要质量指标的依从性得到了提高。包括基准制定和知识共享在内的质量改进协作显示出对提高护理质量的有效性。背景：对于骨质疏松性髋部骨折的老年患者，遵守指南是具有挑战性的。因此，本研究的目的是通过对标和知识共享来提高这些患者对质量指标（QIs）的依从性。方法在比利时法兰德斯的19家医院开展了一项前瞻性多中心研究。测量23个QIs的依从性。在2018-2019年（测量期（MP） 1）和2021年（MP 2）进行了两次回顾性审计（基于患者记录分析）。在两次审计之间，向参与中心提供匿名基准测试，并就特定主题进行了三次教育会议。结果共纳入1044例患者。在MP 1时，显示最低依从率的QIs是给药神经阻滞、类固醇和氨甲环酸，分别只有8.0%、9.7%和22.2%的患者使用。在MP 2时，这些依从率分别显著提高到25.4%、26.4%和30.7% （p < 0.001）。两期患者的出院计划起始指征也有显著改善（mp1组为89.3%，MP2组为93.7%,p = 0.043），术中降压的避免较差（mp1组为56.2%，MP2组为52%，p = 0.026）。总体依从性从61.7%显著增加到64.5% （p < 0.001）。谵妄明显减少（从mp1的22.1%降至mp2的17.4%,p = 0.030）。结论对标结合同行评议和知识共享干预可提高老年髋部骨折患者对质量指标的依从性。

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来源期刊

Archives of Osteoporosis ENDOCRINOLOGY & METABOLISMORTHOPEDICS -ORTHOPEDICS

CiteScore

5.50

自引率

10.00%

发文量

133

期刊介绍： Archives of Osteoporosis is an international multidisciplinary journal which is a joint initiative of the International Osteoporosis Foundation and the National Osteoporosis Foundation of the USA. The journal will highlight the specificities of different regions around the world concerning epidemiology, reference values for bone density and bone metabolism, as well as clinical aspects of osteoporosis and other bone diseases.