Stanford Study Compares Success of Time to Surgery Improvement Programs

Sarasota, FL (WorkersCompensation.com) – Some studies suggest that 65 percent of employees return to work within 12 months after a hip fracture, and that the odds for returning to work may be reduced by 78 to 89 percent for each ten year increase in age. Additionally, those workers with a pre-injury disability are 79 percent less likely to return to work than those peers without issues prior to an injury.

The initial average cost for a hip fractured have been estimated at around $7,000, with a total cost of around $21,000 the first year. Some researchers speculate that the number of hip fractures will more than double due in part to an aging population. Currently, on average 300,000 adults are hospitalized each year for hip fractures.

While age is a factor in recovery of a hip fracture, time to surgery is also an important element as longer time to surgery has been associated with postoperative complications and death. Some studies have shown that a delay of 48 hours has been associated with a 41 percent increase in the odds of mortality within 30 days, and a 32 percent increase in mortality within 1 year.

Researchers from the Orthopedic department at Stanford University asked the question, what key elements are a factor to the success of improvement programs aimed at reducing time to surgery for hip fracture patients. Using the Expert Recommendations for Implementing Change, researchers cataloged improvement programs and identified their results accordingly.

The researchers conducted searches in peer review journals from 3 medical databases using terms such as, hip fracture, time to treatment, surgery, and intervention. Gleaning 1,683 studies from their search, the researchers narrowed down the pool to 69 studies. Of the 69 program studies, 49 significantly decreased time to surgery, and the remaining 20 did not.

Some of the key factors among those programs that made a significant improvement in time to surgery included support of clinicians, engagement with patients, blueprinting, training of stakeholders, and continual re-examination of implementation. Additional elements included identifying champions of care, developing resource-sharing agreements, developing clinical teams that meet on a regular basis, and integration of care with other specialties as needed.

The researchers believe the results of the study highlight the need for understanding the facility and patient-level factors involved with the implementation of time to surgery improvement programs. They hope that results of the study may be beneficial in developing new improvement programs.

Share This Article: