Mrs Monique Adams1
1Northern Local Health Network, Elizabeth Vale, Australia
Biography:
Monique Adams is a Senior Orthopaedic Physiotherapist with 15 years of clinical experience in musculoskeletal physiotherapy and acute orthopaedics. Graduating from the University of South Australia in 2007, Monique has experience in private practice, public outpatients, and acute orthopaedics. She held the Senior Orthopaedic role in the Northern Adelaide Local Health Network (NALHN) for 7 years. In recent years, Monique's focus has shifted to project management and supporting research projects within NALHN Allied Health division. Her involvement in the RISE project, presented today, has been particularly successful, culminating in a successful grant application and a NALHN Staff Award for Sustainability.
Abstract:
Introduction:
Hip fractures represent the highest proportion of hospital admissions of any fracture. With an ongoing state of bed-block, Australian hospitals must consider ways to reduce patient length of stay (LOS). This study aimed to determine the impact of an early and intensive 7-day multidisciplinary care program for patients with neck of femur fracture (NOF).
Method:
A quality improvement approach was adopted. Patients commenced the RISE program within 24 hours of orthopaedic management. RISE patients, in addition to daily physiotherapy (usual care), received two additional therapy sessions per day, provided by Allied Health Assistants. Primary outcomes included length of stay (LOS) on the acute ward and service LOS (for patients transferred to IPR), patient satisfaction and discharge destination. Outcomes were compared to a historical data set.
Results:
Analysis (RISE n=89 and historical n=48) demonstrated similar patient demographics (mean (SD) age 78.9 (9.2) and 76.5 (13.6) years respectively). Patients who received RISE had a median (IQR) acute LOS of 4 days compared to 6.5 in the historical group (p=0.007). Patients in the RISE groups were more frequently referred to inpatient rehabilitation (IPR) (p >0.5), however total service LOS was shorter (RISE 19.5 days compared to historical 22.5 days, p=0.007). Patients experienced the program positively.
Outcome:
Early and intensive therapy post-NOF surgery, using an alternative workforce model, is feasible and can reduce LOS. The RISE model of care may significantly impact on cost and contribute to reducing health care system burden while accelerating patient recovery.