The study is done in St. Vincent Hospital, Melbourne, Victoria in October 1, 1997 to November 30, 1998. It has 111 patients with 80 women and 31 men with mean age of 81 years old. They have found that a proactive multidisciplinary approach can reduce the length of stay. The study also shows that early intervention is another way to reduce the stay in the hospital therefore the risk of having complications brought about by the longer stay in the hospital has lessen. St. Vincent Hospital includes patients with language and cognitive difficulties. Since not all of their population does not speak English. They believed that the inclusion would test the efficacy of clinical pathways in the delivery of multidisciplinary care. Also during the study they found no significant clinical difference in time of mobilization or complication or readmission rates. Possible explanation includes the frequent existence of unstable and often untreated premorbid conditions in patients with fractured neck of femur, which requires attention during their acute admission. In contrast, patients undergoing elective joint replacement have the benefit of preadmission assessment clinics which may resolve expected medical, allied health or discharge issues before admission.. ( Choong , Langford, Dowsey, Santamaria 2000 )
The report of the South Tyneside health Care Trust in 2003 whi...
The pathway starts at the waiting after the Triage to see the A&E doctor, which could be up to an hour since patient with these case are given low priority. Another hour of waiting for the X-ray department since they could handle one patient at a time. The next wait would be for the porter staff to come to take the patient to the X-ray Department and again, once the X-rays have been taken, another one to bring the patient back to A&E. The films had then to be interpreted by the A&E doctor, who may not have been immediately available. Once the diagnosis has been made, the orthopedic doctor on duty had to see the patient and the transfer to the ward again another wait for the porter. They want to make the pathway much easier for the patient they make a study and make necessary adjustment to lessen the waiting time. The changes were made, on arrival the patient is seen by a senior A&E nurse who has undergone appropriate training. The nurse assess the patient's need for analgesia and administer it according to protocol. The A&E Nurse fills out the X-ray request form and contacts the X-ray Department. The Bed Coordinator is contracted and warned of the portable need for an orthopedic bed. The patient is offered the use of a cordless telephone to contact relatives and or neighbors. The patient is taken to the X-ray department and the films taken. Once the radiographer made necessary impression the radiographer notifies the A&E. Since the patient will take only for a few minutes in the x-ray department the porters will wait for her and take the patient directly to the orthopedic ward. If no fracture is seen, the patient is returned to A&E for further assessment. The