National Hip Fracture Database
National Falls and Fragility Fracture Audit Programme (FFFAP)
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Annual reports

15 years of quality improvement

The 2023 National Hip Fracture Database report on 2022

The National Hip Fracture Database (NHFD) 2023 annual report is designed to help local hip fracture teams make the most of the NHFD website’s resources, recommending five quality improvement projects focused on a set of key performance indicators.

The NHFD website is designed as a quality improvement (QI) platform, making data available through a portfolio of interactive run charts and benchmarking tables. This ready availability of open-access, real-time data means that this, the NHFD’s 15th annual report, can be more focused than ever before. It emphasises the importance of quality improvement with five specific improvement focuses, and in particular reports on two KPIs that are designed to examine the very first and final stages of each patient’s care.

Key recommendations

Hip fracture and hospital teams should:

• look at the guidance and resources on the Royal Osteoporosis Society website designed to improve patients’ recovery through better organisation of their care.

• review care in the Emergency Department (ED), so that patients are promptly seen, offered pain relief, and admitted to an appropriate specialist ward within four hours.

• use the NHFD website to see why surgery is delayed and work together so that this happens by the day after patients present with a hip fracture.

• use the NHFD website to see what can be done to avoid patients becoming confused so that they are well enough to get out of bed by the day after their operation.

• ensure that all patients are offered injectable bone strengthening treatment before leaving hospital, or followed up to support their continuing on oral forms of treatment.

Quality improvement focuses

1. Review approaches to monthly hip fracture governance meetings
2. Ensure that patients reach an appropriate bed promptly
3. Ensure that patients receive prompt and appropriate surgery
4. Ensure that patients are ready to get up by the day after their operation
5. Ensure that patients are supported to receive bone protection

            Before the National Hip Fracture Database (NHFD) was established, a hip fracture was viewed with fatalism by patients, their families and by the hospital staff looking after them. The care and outcome of this injury has improved immeasurably since, and measurements made by the NHFD over 15 years of reporting have been used to build the Royal Osteoporosis Society's ‘toolkit’ to ensure that such improvement continues.Antony Johansen, NHFD orthogeriatrician clinical lead