BackgroundOn April 1, 2007, a clinical pathway for hip fracture patients was introduced at Lund University Hospital, Sweden. In this pathway, the emergency department was bypassed and the patient taken directly to the ward via X-ray. In 2009, a similar pathway was implemented at the nearby Helsingborg County Hospital.

Objective

The objective was to analyse possible time gains with this new pathway at a university hospital and a county hospital within the same geographical region.

Patients and methods

Data were retrieved from the Swedish National Hip Fracture Register, patient charts and the X-ray databases. Patients were divided into pathway group (PG) and non-pathway group (NPG). Lead times analysed were—arrival to X-ray, X-ray to surgery, arrival to surgery and total length of stay.

Results

Between April 1 and December 31, 2007, 367 hip fracture patients were admitted to Lund University Hospital, 118 were PG. There was a time gain for the PG from arrival to X-ray but not in the other lead times.

Between April 1 and December 31, 2009, 322 hip fracture patients were admitted to Helsingborg County Hospital, 221 were PG. All lead times were shorter in the PG.

Conclusion

The introduction of a hip fracture care pathway resulted in a time gain to X-ray in both hospitals but to surgery only in the county hospital. The causes for this may include different implementation processes and previous care optimization.