Authors (including presenting author) :
Yim TK(1), Hsu YCA(2), Chu KK(2)
Affiliation :
(1)Department of Medicine and Geriatrics, United Christian Hospital (2) Department of Orthopedics and Traumatology, United Christian Hospital
Introduction :
The fracture liaison service in United Christian Hospital, was developed from a primitive ortho-geriatric collaboration model to meet the core values of World Health Organization of Integrated Health Services. This experience can be applicable to other service development of Hospital Authority that involving the care of geriatric patients.
Objectives :
Using Fracture Liaison Service for hip fracture patients as a model, to illustrate the importance of collaboration among different specialties, and to demonstrate delivering coordinated service with international standards to meet the challenge of ageing population.
Methodology :
To describe the milestones of Fracture liaison service development in United Christian Hospital, and illustrate how to extrapolate the model of care to other medical fields involving geriatric patients. Our service meets the core values of World Health Organization integrated Health care model, by fostering collaboration among professionals across settings, to fight fragmentation of service provision, and deliver services that are aligned with the needs of geriatric patients.
Result & Outcome :
Dating back to 1990s, the ortho-geriatric service was started in the acute orthopedic wards. The passion and dedicated effort inspired other professionals, and the multi-disciplinary team was formed. Weekly multi-disciplinary round provides a platform for knowledge exchange and transfer. A database was created to capture the clinical information of more than 2000 hip fracture patients in 2012. This database guided our further direction of service development. With the support of Hospital Authority, a designated elderly friendly acute ortho-geriatric ward, with a designated post of Fracture liaison nurse as the central key coordinator was available in 2017. From July 2019, Geriatric team offer daily geriatric input to all hip fracture patients in the acute ward. A new database is created from July 2019, aiming at analyzing not only surgical parameters, but also the geriatric perspectives including frailty and cognitive function assessment, and the bone health status, to facilitate our better understanding of the expanding need of ageing population and the service gap. We are conducting a 5 year outcomes evaluation based on the 2012 database, which we believe it will be the first study on the long term outcomes of geriatric hip fracture patients in Hong Kong.
