Functional improvement through interdisciplinarity

A few weeks ago, the Government of Navarra recognised us with the 'Navarra' Dependency Care Prize for the work of our Orthogeriatric Unit in the treatment of patients with hip fractures, "aimed at achieving functional improvement and readjustment to daily life through rehabilitation, the prevention of new falls and its systems of innovation in ageing".

This award, of which we are obviously proud, gives us the opportunity to generate a series of posts, in which we will try to transmit our conclusions and learning over time.   

It is in 2010, in collaboration with the Basque Government's Department of Health, that we will start up the Orthogery Unit at Matia Fundazioa's Bermingham Hospital. The challenge is to recover our walking and loss of autonomy as a result of the hip fracture.

The Unit, which in these two years has attended to more than 500 people with an average age of over 80, receives patients from 2 acute hospitals in the area, with a referral protocol 4 days after surgery. The patients attended have a clinical situation that does not require acute hospital intervention, a Barthel index at discharge in acute cases of less than 60 and a previous Barthel index of more than 30.

From their admission, we begin with the application of our care model, based on integrality and interdisciplinary care through

• A geriatric assessment with the setting of care objectives and the development of an individualised care plan.
• A model of care and intervention planned and executed by an interdisciplinary team (geriatric doctor, nurse, assistant, physiotherapist, occupational therapist and social worker)
• A functional recovery treatment based on physiotherapeutic intervention to recover walking autonomy and supported occupational therapy aimed at recovering autonomy in other basic activities of daily life such as cleaning or dressing.
• Guidance on modifications at home or the use of technical aids that can increase the patient's autonomy and safety, also contemplating continuity upon discharge and follow-up after 6 months.

As a relevant result, the Unit has contributed to significantly increase the functional improvement and adaptation of the people assisted, as well as to decrease the avoidable dependence, making possible a lesser institutionalisation with the consequent personal benefit and efficiency in the social-health cost.

From now on, a new phase begins. We have set ourselves a new challenge to face the evidence that between 5% and 15% of patients present second hip fractures. The innovation lies in the fact that, in addition to being oriented towards functional recovery, we also want and must influence the modification of factors that favour the fall.

The objective of the next posts will be to keep you informed of the progress of the Unit and of our Care Model. We will do so in terms of improvement and professional usefulness. While we are preparing them, do not hesitate to send us your comments, questions or proposals. Only in this way will we continue to advance together for greater well-being.