3022 Using the Irish Hip Fracture Database to drive improvement in older adult care

Abstract Introduction The Irish Hip Fracture Database (IHFD) is a national clinical audit managed by the National Office of Clinical Audit, that measures the quality of care and outcomes of hip fracture patients aged over 60 years. Annually there are 4000 hip fractures, the median age of a patient is 81 and 66% are female. 84% are admitted from home, 12% from a nursing home and 95% are caused by a low trauma fall. Method Data is collected through the Hospital In-patient Enquiry (HIPE) system. Care is measured against 7 clinical standards and two data quality standards and since the IHFD 2018 this have been linked to a Best Practice Tariff payment. The hospital with the highest compliance in the standards is awarded the ‘Golden Hip Award’. Results To date the IHFD has reported on 11 years of data. There have been statistically significant improvements in all standards between 2013–2023. In 2023 the data showed that 29% were admitted through ED within 4 hours, 75% had surgery within 48 hours, 4% developed a pressure injury, 83% were seen by geriatrician or Advanced Nurse Practitioner, 87% had bone health assessment, 83% specialist falls assessment and 87% were mobilised on the day after surgery (87%). Other data shows that 82% get a pre-op nerve block, 71% have a nutritional screen, 49% had a delirium screen day 1, 24% achieved independent mobility, 25% were discharged home directly, 38% went to rehabilitation and the median length of stay was 12 days. Conclusion This data has led to the development of a national hip fracture bypass pathway, orthogeriatric services in each hospital and quality improvement is embedded in each hospital through their hip fracture governance committee. The IHFD is an exemplar of how to get care right for older adults.