A & E FAST-TRACKING OF PATIENTS WITH A NECK OF FEMUR FRACTURE: IS IT SAFE?

Frail patients with neck of femur fracture, amongst other medical problems, are frequently fast-tracked to orthopaedic wards to meet government A&E waiting time targets.This is a second cycle of audit since 2008 examining the safety of fast-tracking following individual critical incidents. Data was collected prospectively between March and June 2011 by the first on-call orthopaedic doctor.56 patients (12 male), average age 81.2y (50–97) were fast tracked. 52 were correctly referred as intra/extracapsular fracture, however 4 did not have a neck of femur fracture. 9 patients were transferred with no verbal referral to the receiving orthopaedic doctor. On arrival to the ward, 8 patients were found to have abnormal observations and acute medical problems requiring immediate review from the physicians. There were a total of 150 omissions from a total of 456 points from the fast track protocol. Vital observations of patients fast-tracked after 2100h were worse (MEWS range 0 to 11) when compared with those fast-...