Hip Fracture - Quality Statement 2: Surgery Within 48 Hours

Resources Quality Statements Advisory Committee About

Surgery Within 48 Hours

Patients with hip fracture receive surgery as soon as possible, within 48 hours of their first arrival at any hospital (including any time spent in a nonsurgical hospital).

Background

Hip fracture patients requiring surgery should receive surgical intervention as soon as possible, within a maximum of 48 hours of their first presentation to a hospital, regardless of whether they are subsequently transferred to another hospital for surgery. Increased time to surgery causes prolongation of pain, extended inpatient stay, and is associated with increased morbidity and mortality.

What This Quality Statement Means

For Patients

You should have surgery on your hip fracture within 48 hours of arriving at the hospital, even if you need to be transferred to a different hospital to have your surgery.

For Clinicians

If you know that your patient has a hip fracture and requires surgery, ensure that they are operated on as soon as possible, and no more than 48 hours after arrival at any hospital.

For Health Services

Ensure that systems, processes, and resources are in place to ensure rapid surgical intervention for people with hip fractures. This includes having protocols, hip fracture pathways, medical directives, and standardized order sets in place to ensure that the 48-hour target is met.

Quality Indicators

Process Indicators

Percentage of patients who underwent hip fracture surgery who had surgery within 48 hours of first arrival at any hospital

Denominator: total number of adults admitted to hospital with a primary diagnosis of fragility hip fracture who undergo surgery for hip fracture
Numerator: number of people in the denominator who underwent surgery within 48 hours of first arrival at any hospital
Data source: Discharge Abstract Database, National Ambulatory Care Reporting System

Median and 90^th percentile number of hours patients wait to receive hip fracture surgery following first arrival at any hospital

Data source: Discharge Abstract Database, National Ambulatory Care Reporting System

Evidence to Improve Care