1015 Reducing Waiting Time to Surgery for Patients with Femoral Peri-Prosthetic Fractures (FPP#s): A Quality Improvement Project

Abstract

Abstract Introduction Research has shown that early fixation and return to mobility in femoral fragility fractures improves post-operative outcomes. Based on this, in patients with neck of femur fractures (NOF#), NICE guidelines advise fixation ‘on the day of or the day after admission’. However, no guidelines exist in the case of femoral periprosthetic fractures (FPP#) despite emerging evidence showing improved outcomes in this cohort of patients also. Method We retrospectively analysed the waiting times from admission to surgery for NOF#s and FPP#s admitted between 1/9/20 to 1/4/21 at St. Richard's and Worthing Hospitals that required surgery. 30 FPP# and 503 NOF# patients were admitted during this period. Data was collected on all FPP# patients and a randomly selected cohort of 30 patients from the NOF# group. Results There was an average waiting time of 1.3 days for NOF#s and 3.7 days for FPP#s from admission to surgery. Conclusions This initial data demonstrates the longer waiting times for FPP# patients. We identified key areas where improvements could be sought decreasing time until CT scanning for evaluation of fracture pattern and decreasing time until a specialist opinion from a hip surgeon to decide between operative fixation or conservative management. By addressing these and educating team members about the positive outcomes by reducing delays to surgery in FPP# patients we hope to decrease their waiting times. We are currently re-auditing to identify any improvements and any further facets for advances in the future.