Foundations for Developing a Hospital in the Home Pathway Following Low Trauma Hip Fracture: Using Data to Inform the Path

Naylor, J; Bui, TA; Frost, S; McEvoy, L; Harris, I; Lim, C; Radkakrishnan, S; Johns, N; Brady, B; Tcharkhedian, E; Lieu, D; Dickson, H; Penm, J; Kimmel, L; Sidhu, B; Ni Chroinin, D

Foundations for Developing a Hospital in the Home Pathway Following Low Trauma Hip Fracture: Using Data to Inform the Path

Naylor, J Bui, TA Frost, S McEvoy, L Harris, I Lim, C

Radkakrishnan, S Johns, N Brady, B Tcharkhedian, E Lieu, D Dickson, H Penm, J Kimmel, L Sidhu, B Ni Chroinin, D

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Publisher:: SAGE Publications
Publication Type:: Journal Article
Citation:: Home Health Care Management and Practice, 2025, ., (.), pp. .-.
Issue Date:: 2025-01-11

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Field	Value	Language
dc.contributor.author	Naylor, J
dc.contributor.author	Bui, TA
dc.contributor.author	Frost, S
dc.contributor.author	McEvoy, L
dc.contributor.author	Harris, I
dc.contributor.author	Lim, C https://orcid.org/0000-0002-2837-0973
dc.contributor.author	Radkakrishnan, S
dc.contributor.author	Johns, N
dc.contributor.author	Brady, B
dc.contributor.author	Tcharkhedian, E
dc.contributor.author	Lieu, D
dc.contributor.author	Dickson, H
dc.contributor.author	Penm, J
dc.contributor.author	Kimmel, L
dc.contributor.author	Sidhu, B
dc.contributor.author	Ni Chroinin, D
dc.date.accessioned	2025-01-12T00:07:11Z
dc.date.available	2025-01-12T00:07:11Z
dc.date.issued	2025-01-11
dc.identifier.citation	Home Health Care Management and Practice, 2025, ., (.), pp. .-.
dc.identifier.issn	1084-8223
dc.identifier.issn	1552-6739
dc.identifier.uri	http://hdl.handle.net/10453/183268
dc.description.abstract	<jats:p> Care pathways incorporating Hospital in the Home (HITH) programs are available for people following low-trauma (osteoporotic) hip fracture (LTHF) as a strategy to reduce total length of stay (LOS), but there is no published evidence supporting the development of key components of such programs for this specific population. As a precursor to program implementation, a multidisciplinary team devised criteria for HITH eligibility and considerations for readiness for HITH transfer. This study aimed to describe the rates and timing of suitability for HITH when these criteria and considerations were applied prospectively to adults admitted with LTHF who underwent surgical fixation. Prospective, 5-month audit of patients admitted to a single facility following LTHF. Criteria for HITH inclusion/exclusion and 3 time-based safety considerations for readiness for HITH transfer (time [post-operative day, POD] to first complication, time to medical stability, time to mobilization threshold) were applied to patient-level data routinely available in the medical record. Eligibility: Of 114 patients screened, 61 (54%) were initially eligible with 41 (36%) remaining eligible over the episode-of-care. Transfer considerations: 75% of those who experienced a complication did so by POD4; 75% achieved medical stability by POD5; 75% achieved the mobility criterion by POD7; and, 75% of patients met all criteria by POD7. Using data-informed criteria and considerations, we estimate that one-third of LTHF patients will be eligible for HITH with most ready for transfer within a week post-surgery. A HITH program using safety-focused criteria may help reduce LOS for patients with LTHF. </jats:p>
dc.language	en
dc.publisher	SAGE Publications
dc.relation	Maridulu Budyari Gumal - The Sydney Partnership for Health, Education, Research and Enterprise (SPHERE)
dc.relation.ispartof	Home Health Care Management and Practice
dc.relation.isbasedon	10.1177/10848223241296871
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1110 Nursing
dc.subject.classification	Nursing
dc.subject.classification	4205 Nursing
dc.title	Foundations for Developing a Hospital in the Home Pathway Following Low Trauma Hip Fracture: Using Data to Inform the Path
dc.type	Journal Article
utslib.citation.volume	.
utslib.for	1110 Nursing
pubs.organisational-group	University of Technology Sydney
pubs.organisational-group	University of Technology Sydney/Faculty of Health
pubs.organisational-group	University of Technology Sydney/UTS Groups
pubs.organisational-group	University of Technology Sydney/UTS Groups/Improving Palliative, Aged and Chronic Care through Clinical Research and Translation (IMPACCT)
pubs.organisational-group	University of Technology Sydney/UTS Groups/UTS Ageing Research Collaborative (UARC)
pubs.organisational-group	University of Technology Sydney/UTS Groups/Digital, Virtual and AI in Health Collaborative (DVAIHC)
pubs.organisational-group	University of Technology Sydney/UTS Groups/The Trustworthy Digital Society
utslib.copyright.status	closed_access	*
pubs.consider-herdc	true
dc.date.updated	2025-01-12T00:07:09Z
pubs.issue	.
pubs.publication-status	Published online
pubs.volume	.
utslib.citation.issue	.

Abstract:

Care pathways incorporating Hospital in the Home (HITH) programs are available for people following low-trauma (osteoporotic) hip fracture (LTHF) as a strategy to reduce total length of stay (LOS), but there is no published evidence supporting the development of key components of such programs for this specific population. As a precursor to program implementation, a multidisciplinary team devised criteria for HITH eligibility and considerations for readiness for HITH transfer. This study aimed to describe the rates and timing of suitability for HITH when these criteria and considerations were applied prospectively to adults admitted with LTHF who underwent surgical fixation. Prospective, 5-month audit of patients admitted to a single facility following LTHF. Criteria for HITH inclusion/exclusion and 3 time-based safety considerations for readiness for HITH transfer (time [post-operative day, POD] to first complication, time to medical stability, time to mobilization threshold) were applied to patient-level data routinely available in the medical record. Eligibility: Of 114 patients screened, 61 (54%) were initially eligible with 41 (36%) remaining eligible over the episode-of-care. Transfer considerations: 75% of those who experienced a complication did so by POD4; 75% achieved medical stability by POD5; 75% achieved the mobility criterion by POD7; and, 75% of patients met all criteria by POD7. Using data-informed criteria and considerations, we estimate that one-third of LTHF patients will be eligible for HITH with most ready for transfer within a week post-surgery. A HITH program using safety-focused criteria may help reduce LOS for patients with LTHF.

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http://hdl.handle.net/10453/183268