Avera McKennan Launches Geriatric Fracture Program
SIOUX FALLS (June 2, 2011) – The orthopedic unit at Avera McKennan Hospital & University Health Center has opened the region’s first Geriatric Fracture Program to ensure that the best possible care is delivered to elderly patients with serious fractures.
In the program, Avera McKennan is focusing on hip fractures as these are often the most serious and life-changing type of fracture that older people experience. Approximately 350,000 people each year in the United States are hospitalized due to hip fracture. Mortality for a senior citizen who breaks a hip is at least 25 percent. Of those who survive, only 20 percent are able to return home with the same function they enjoyed beforehand. Well-coordinated care and patient and family education can help improve a patient’s chances for recovery, and help ensure that patients don’t develop complications which can impede their recovery.
“We are on the verge of an epidemic of osteoporotic fractures in the aging population. It is imperative that we utilize evidence-based medicine when treating these fractures to optimize outcomes. The Geriatric Fracture Program at Avera McKennan accomplishes that goal,” said Erik Peterson, MD, orthopedic specialist and surgeon with CORE Orthopedics Avera Medical Group.
When a hip fracture occurs, Avera providers immediately refer the case to the Avera McKennan Emergency Department. A specific plan of care and order sets are put into motion, providing expedited care for the patient.
“The Geriatric Fracture Program is a compilation of best practices, from diagnosis of fracture, to pre-operative decisions, to medications given before and after surgery, to recovery and rehabilitation,” said Mary Wilson, director of Hospital Medicine and Clinical Orthopedics at Avera McKennan.
It involves an interdisciplinary team approach to fracture care, including orthopedic surgeons and primary care physicians; anesthesiologists; nurses, many of whom have specialized training in orthopedics; physical therapists and occupational therapists; social workers; and case managers.
“The Geriatric Fracture Program is a way to standardize and improve fracture care in the elderly. It is based on improving outcomes and decreasing perioperative problems related to the geriatric population,” said Eric Watson, MD, orthopedic specialist and surgeon with Orthopedic Institute.
Education is a key component, which begins with the family and patient as soon as possible after the time of fracture. Avera McKennan’s focus is getting hip fracture patients to surgery within 24 hours of their fracture. When patients have surgery sooner, they face fewer complications such as skin breakdown or pneumonia resulting from hospitalization and being immobile. The most common surgical approaches to repair a hip fracture include a total joint replacement, hemi-arthroplasty or open reduction and internal fixation.
After surgery, education provided by a community educator, therapists and nurses continues in the 2 West orthopedic unit at Avera McKennan, involving both the patient and his or her family.
A key goal is discovering the reason for the fracture, and taking steps to prevent re-injury or future fractures. “So many times, fixing the fracture is the main concern rather than fixing the reason why it occurred,” said Nancy Klinkhammer, community educator for Avera McKennan’s Physical Medicine and Rehabilitation department. Education also acquaints patients and their families with possible resources, such as osteoporosis screening, inpatient rehabilitation if needed, or outpatient physical or occupational therapy.
“With our aging population, fractures are an ever-increasing occurrence,” Klinkhammer said. The National Center for Injury Prevention and Control reports that the number of U.S. residents age 65 and older is projected to more than double from 35 million in 2000 to more than 77 million in 2040. Three times as many people will suffer a hip fracture in 2050 than in 1990. “The best scenario is to prevent fractures in the elderly, through safety measures to prevent falls as well as osteoporosis screening, and taking Vitamin D with calcium supplements. Yet when a fracture does occur, we want to remain prepared to give these patients the best possible care, for the best possible outcomes,” Wilson said.