[AVBC 2025] Improving Time to Surgery for Geriatric Hip Fracture Patients with Surgery
Care Process & Redesign
Appropriate & Value-based Care Conference
SingHealth
17 November 2025
To increase the proportion of geriatric hip fracture patients with surgery done within 48 hours of Emergency Department (ED). A standardized care pathway with multidisciplinary coordination improved time to surgery and reduced LOS, leading to substantial.
Year Submitted: 2025
Published Date: 17 November 2025
Tags: Care Process ＆ Redesign, Quality Improvement, Workflow Redesign, Productivity, Cost Saving, Time Saving, Access To Care, Length Of Stay, Waiting Time, Value Based Care, Adverse Outcome Reduction
About this Content
Aims
To increase the proportion of geriatric hip fracture patients with surgery done within 48 hours of Emergency Department (ED) registration from 35.3% to 60% in 12 months.
Background
Hip fractures in the elderly population are associated with significant mortality rates of up to 22% within the first year and functional decline, with only 40-60% of survivors regaining their pre-fracture level of mobility and independence. Timely hip fracture surgery within 48h has been associated with lower 12-month mortality rates and better post-operative outcomes.
Methods
A multidisciplinary team comprising Orthopedic surgery, Anesthesiology, Geriatrics, Cardiology, and Office of Value Based Healthcare was set up to improve time to surgery. Process mapping was done to identify steps from ED registration to surgery. Interventions included addressing medical-related delays and OT availability issues.
Results
Patients receiving surgery within 48 hours increased from 35.3% in 2023 to 62.3% in 2024. The proportion of patients with total length of stay (LOS) 10 days increased from 40.3% in 2023 to 59.3% in 2024. The average total LOS decreased from 15.2 days in 2023 to 11.7 days in 2024, resulting in cost avoidance of over $1,100,000 in 1 year.
Conclusion
A standardized care pathway with multidisciplinary coordination improved time to surgery and reduced LOS, leading to substantial bed-days and cost avoidance.
Lessons Learnt
Implementing a standardized care pathway with multidisciplinary coordination successfully improved time to surgery for hip fracture patients. Regular audits and performance monitoring facilitated by automated dashboards ensure sustainability.
Keywords
Geriatric, Hip Fracture, Surgery, Time to Surgery, Cost Avoidance
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | SingHealth |
Organization(s) Involved | Singapore General Hospital |
Platform(s) | Appropriate & Value-based Care Conference |
Healthcare Professional Group(s) | Medical |
Applicable Specialty or Discipline | Orthopaedics, Surgery |
Project Lead(s) | Joyce Koh Suang Bee |
Project Member(s) | Tan Wen Jia |
Connect with this contributor!
Tan Wen Jia - tan.wen.jia@sgh.com.sg
Project Attachment
1072_SGH_AVBC 2025_Improving Time to Surgery for Geriatric Hip Fracture Patients with Surgery.pdf