Abstract
Purpose/Objectives: Hip fractures among the elderly increase the incidence of mortality and other health-related complications, lead to poor quality of life, and create major economic challenges. Elderly individuals often reside in rural skilled nursing facilities (SNFs) for rehabilitation after undergoing surgical fixation for a hip fracture. Orthopedic providers (OPs) can develop protocols that will encourage continuity of postoperative orthopedic follow-up care, guiding and educating SNF staff in best practices, and encouraging regular communication between SNF staff and OPs. The purpose of this article is to describe how an orthopedic practice developed a universal postoperative hip instruction protocol (UP-HIP) to promote a streamlined approach to postoperative follow-up assessment and rehabilitation for the elderly residing in rural SNFs. The overall goal of the UP-HIP is to provide the OP with assessment findings remotely and avoid putting frail elderly patients at risk by physically transporting them to and from follow-up appointments with the OP.
Primary Practice Setting(s): Orthopedic clinic setting and rural SNFs.
Findings/Conclusions: Comprehensive postoperative protocols focused on elderly patients with hip fracture in rural SNFs serve to improve remote communication during the rehabilitation phase and guide SNF in a coordinated approach to postoperative follow-up care. Future recommendations include the addition of telehealth technology to allow for remote real-time visual assessments by the OP while the elderly patient with hip fracture remains in the SNF environment.
Implications for Case Management Practice: The UP-HIP allows the OP and case manager to ensure continuity of postoperative care by conducting remote follow-up postoperative visits with elderly patients with hip fracture while they remain in the rural SNF setting. Comprehensive evidence-based protocols assist OPs and case managers with remotely monitoring rehabilitation progress in the rural SNF setting more efficiently and consistently. Telehealth technology added to evidence-based protocols enables the OP and case manager to conduct real-time visual assessments of the patient without the patient having to leave the rural SNF setting.