Authors (including presenting author) :
Li TL (1), Man KH (1), Fung KW (1), Yu LF (1), Wong KK (1)
Affiliation :
(1) Department of Orthopaedics and Traumatology, Kwong Wah Hospital
Introduction :
Geriatric hip fractures have become a global health concern. An e-system of virtual orthogeriatric ward which focuses on preoperative period was implemented in Kwong Wah Hospital since 2017. Before virtual orthogeriatric ward, geriatric and anesthesia consultation is only available on request. The implementation of virtual orthogeriatric ward provides a multidisciplinary communication platform between orthopaedics surgeons, geriatricians, anesthetists and nurses to provide timely assessment.
Objectives :
(1) To evaluate the efficacy of virtual orthogeriatric ward in improving clinical outcomes for hip fracture patients. (2) To speed up preoperative preparation by providing timely orthogeriatric medical support.
Methodology :
A pre-post intervention, retrospective cohort study was used to compare geriatric hip fracture data before virtual orthogeriatric ward (n=30) and after virtual orthogeriatric ward (n=30). The efficacy of virtual orthogeriatric ward was evaluated by comparing subspecialty consultation time and time to surgery. Clinical outcomes were analyzed by performing satisfaction survey.
Result & Outcome :
After the implementation of virtual orthogeriatric ward, consultation time of geriatricians and anesthetists is significantly shortened from 3.47 days to 1.13 days (p< 0.0001, mann-whitney U test). Proportion of surgery within 48 hours of admission was increased from 20% to 53.3% (p=0.0015, mann-whitney U test). Orthopaedics surgeons, geriatricians, anesthetists and nurses agree that virtual orthogeriatric ward is effective by providing timely preoperative assessment and improves efficiency in managing perioperative complications.
Virtual orthogeriatric ward brings positive impacts to hip fracture patients with early detection of medical problems and provide prompt intervention. It improves clinical outcomes and standard of care resulted from orthopaedics surgeons, geriatric, anesthesia and nurses optimization.
