Tuesday, April 02, 2019

Hip Fracture Bundle Results in Time and Cost Savings Through Better Care Service Integration


Madam Tan So Lew, 78, was admitted to Tan Tock Seng Hospital in early January 2019 due to a fall. Instead of the typical rehabilitation period of 29 days, she shaved off the length of her hospital stay to just 16 days. Thanks to the seamless care provided by the Hip Fracture Bundle service, she was back home in time to celebrate the Lunar New Year with her family.

What is the Hip Fracture Bundle Service?

The Hip Fracture Bundle pilot, which runs from October 2016 to September 2019, aims to reduce hospital stay and re-admission rate of hip fracture patients. This is achieved through better integration of post-operative care and rehabilitation services across acute and community hospitals.

Hospitals taking part in this pilot trial are Tan Tock Seng Hospital (TTSH), together with Ren Ci Hospital (RCH) and Ang Mo Kio-Thye Hua Kwan Hospital (AMKTHK), which falls under the Central Region healthcare cluster.

The service offers:

· Seamless transfer from acute hospital (TTSH) to community hospital (RCH or AMKTHK)
· A single clinical care team that develops an integrated care plan and a continuous rehab programme
· Alignment of recovery expectations between the healthcare team and the patient and his/her family
· Improvement of a patient’s ability to handle conditions after discharge
· A reduction of hospital stay duration without compromising the quality of care and outcome

The Ministry of Health (MOH) selected hip fracture for the trial because of the high hip fracture occurrences in seniors after a fall.

With this Hip Fracture Bundle pilot, MOH aims to achieve three things. The first is to support care transformation and ensure clients are reviewed and cared for at an appropriate care environment.

The second is to track common indicators such as average wait times (from date of referral to date of admission) and the average length of stay, as well as focus on patient outcomes.

The third is to strengthen National Health Group’s ability to coordinate better care continuity in the Central Region healthcare cluster.

Patients enrolled in this pilot bundle schemes are based on defined clinical criteria. The trial sees up to 30% admitted patients from TTSH to RCH who required post hip fracture care.

Ren Ci Hospital - Benefits of Hip Fracture Bundle

Since its implementation in 2016, the average wait time for the 488 admissions from TTSH to RCH was reduced by five days. The average post-treatment period shortened from 29 days to 21 days.

“The Hip Fracture Bundle has shown that patients benefit from seamless delivery of care from a multidisciplinary team spanning both hospitals, leading to better rehabilitation outcomes, earlier discharge and also lowers re-admissions during and after the treatment period,” said Mr Joe Hau, CEO of RCH.

Beyond time savings, patients also enjoy cost savings, thanks to the shorter hospital stay and a single-bundled payment scheme. One of the aims of this service is to achieve the long-term goal of delivering affordable healthcare. Patients who receive care at acute hospitals and post-treatment at community hospitals need only pay at one single point. RCH plans to continue partnering TTSH and expand on its bundle treatment types to better serve patients with different care needs.

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