Case study: multidisciplinary hip fracture unit at Careggi University Hospital, Italy
Careggi University Hospital has implemented a multidisciplinary hip fracture unit to improve care, decrease the length of hospital stays and reduce post-surgery complications.1
What does the programme involve?
Established in 2011, this multidisciplinary unit aims to address the needs of older people with multiple chronic conditions who have had a hip fracture.1 Every person who is admitted to the hospital with a hip fracture undergoes a comprehensive series of tests soon after admission, allowing the medical team to identify conditions that may introduce additional risks and to select the most appropriate treatment strategies.2 3 Following surgery, physiotherapists support early mobilisation and osteoporosis treatment is often prescribed.3
What has the programme achieved?
Implementation of the hip fracture unit has supported improvements in fracture management, health service efficiency and patient outcomes:1 2
- The proportion of people who have surgery within 48 hours of admission has increased from 26% to 80%.
- The average length of hospital stay has decreased from 17 to 13.6 days.
- There has been a significant reduction in the rate of deaths, from 3.8% in 2011 to 1.4% in 2016.
What lessons can be learnt from this programme?
The quality of hip fracture care and the efficiency of health services can be significantly improved when patients are managed appropriately by a multidisciplinary team. In addition, hip fracture management pathways can effectively incorporate post-surgery care to support the early mobilisation and initiation of osteoporosis treatment.
The information in this case study is based on research conducted for the 2020 publication Osteoporosis and fragility fractures: a policy toolkit.
- Rostagno C, Cartei A, Civinini R, et al. 2018. Hip fracture unit: beyond orthogeriatrics. Intern Emerg Med 13(5): 637-39
- Rostagno C, Buzzi R, Campanacci D, et al. 2016. In Hospital and 3-Month Mortality and Functional Recovery Rate in Patients Treated for Hip Fracture by a Multidisciplinary Team. PLoS One 11(7): e0158607
- Rostagno C, Cartei A, Buzzi R, et al. 2013. Multidisciplinary approach to hip fracture in the elderly: Florence experience. Emerg Med 3: 148-52