Hip Fracture Registry

Background

xraySuffering a hip fracture usually requires surgery and can result in major life changes. The Hip Fracture Registry supports the epidemiological study of hip fracture procedures from 2009 to present and includes fracture types, procedure types, implant use and outcomes. A main goal of this registry is to compare variation in treatment approaches and outcomes for fractures within the same category. Some of the underlying clinical questions to be addressed pertain to the relationships between outcomes and patient variables, fracture categories, implant characteristics and types of intervention. Still in its infancy, the Registry is a work in progress.

Like many of our newer registries, the hip fracture registry is based exclusively on electronic data extraction. Automatic data capture, high level efficiency and elimination of burden on providers are some of the main benefits of the design of this Registry. A current priority is to identify implant and patient characteristics through enhanced methods of data extraction.

The purpose of the Hip Fracture Registry is to improve the quality of care that we provide to hip fracture patients. The Registry aims to allow us to:

  • Optimize medical care and rehabilitation opportunities
  • Minimize hospital stay and complications
  • Reduce mortality
  • Identify key areas for improvement

Data Collection and Sources

Data sources include Clarity (KPHC), Kaiser Anesthesia and Surgery Information System (KASIS), and Legacy databases dating back to 2009. Data from 6 regions have been included thus far; the Registry plans to include data from the Mid-Atlantic States and Georgia in the near future.

Quality Control and Outcome Validation

To maintain data integrity, automated quarterly quality control procedures are performed using an electronic screening algorithm. ICD-9 codes are used to identify suspected complications including infections, deep vein thrombosis, pulmonary embolism, acute myocardial infarction, pneumonia, dislocation and reoperation. All cases suspected of deep or superficial infection, venous thromboembolism, and/or reoperation are audited via chart review by clinical content experts to determine if they meet pre-established complications criteria. Thrombotic events must occur within 90 days of implant procedure to be classified as positive. Infection complications are tracked according to the CDC/NHSN Guidelines. Deep infections must occur within one year of implant procedure. Superficial infections must occur within 30 days of implant procedure to be classified as an infection. Re-operations are tracked for the lifetime of the patient.

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