The clinical quality indicators for trauma and orthopaedics are:
This indicator measures whether a patient's care achieves a series of 'best practice' criteria. The agreed standards are:
- admission using a care protocol agreed by orthogeriatrician, orthopaedic surgeon, a ward within four hours
- surgery within 36 hours
- shared care by orthopaedic surgeon and orthogeriatrician
- pressure ulcer prevention
- properative assessment by an orthogeriatrician
- assessment of bone health
- falls risk assessment prior to discharge
This indicator shows the proportion of patients whose care met the best practice tariff standards.
Hip fracture is the most common serious injury affecting older people. It is a major cause of mortality, morbidity and loss of independence. Improvements in hip fracture care and reduction of the incidence of further hip fracture by effective secondary prevention are major goals for the NHS and society.
Care that meets the standards of the best practice tariff offers the best outcomes for patients who have suffered a hip fracture.
Our objective is to be in the top 10% of trusts in England when compared to national figures taken from the National Hip Fracture Database.
From Jan-Dec 2013 Barnet Hospital (BNT) attained 76.3% on the best practice tariff, Chase Farm Hospital (CHS) attained 86.4%, and the Royal Free Hospital (RFH) attained 58.3%. Therefore the trust is in line with, or better than, the national average of 60.5%. Chase Farm Hospital performance was in the top 10% of trusts in England.
Surgical site infection rates in the early post-operative period following total hip and total knee arthroplasty. These figures will be compared with infection rates for other institutions.
Source: Health Protection Agency - Surgical Site Infection Surveillance Service (SSISS) (2013/14 Data)
Infection following elective total hip or knee arthroplasty is an uncommon but devastating complication, often requiring further surgical intervention and, in the worst case, revision of the implant.
All hospitals performing hip and knee arthroplasty procedures submit data on early infection rates to the Health Protection Agency's surgical site infection surveillance service.
Our objective is to remain in the top-performing 10% of hospitals with lowest rates of infection after hip and knee arthroplasty.
Comment on current performance
Source: Health Protection Agency - Surgical Site Infection Surveillance Service (2013/14 Data)
This is the clinical quality indicator for the improvement of the outcome of open fracture of the tibia (shin bone) after specialist care.
The British Association of Orthopaedic Surgeons and British Association of Plastic, Reconstructive and Aesthetic Surgeons have established standards of best practice for management of open tibial fractures. These are known as the British Orthopaedic Association Standards for Trauma, BOAST4, guidelines.
Best outcomes are achieved by timely, specialist surgery rather than emergency surgery by less experienced teams. The Royal Free London has specialist teams in both orthopaedic surgery and plastics and reconstructive surgery.