Hybrid hip ERAS
Updated: Sep 5, 2020
There's some great - our hip fracture mortality has significantly decreased during the Covid pandemic whilst we've changed the hip fracture pathway. All your efforts in UHL have obviously been key to achieving this. It seems that putting a subset of hip patients (many intra-capsular fractures, many frail but not incredibly frail) through a 'hybrid ERAS' stream in UHL has dramatically improved nearly all our outcomes - including length of stay, mobilisation post-op and mortality. Surgeons, orthogeriatricians and allied health care are obviously really pleased.
So we want to capture this - formalise a 'hybrid hip' pathway - which is probably somewhere between that of an ERAS THR and the previous pathway for #NOF care.... and then hopefully roll it out on a wider scale - as the NHFD will be interested in our new approach and so will many other hospitals.
Hip fracture care is multidisciplinary and there have been many new key components but it would be essential to have your input in sharing the anaesthetic approach to this new 'hybrid hip pathway'. You've all been doing hips regularly in UHL and I'd be really grateful if some of you would be interested in being part of an initial meeting to formalise patient selection criteria and create an anaesthetic approach to the 'hybrid hip care'. I'm guessing it would be somewhere between the frail NOF pathway and THR ERAS pathway (attached). It wouldn't have to be too prescriptive but a framework to work to.
I was hoping to get a Zoom meeting group together and going from there. If you think there's anyone missing from the group please forward this on to them.
Please just let me know if you'd be interested.
Hip fracture anaesthesia (Welsh guidance):