Establishing an Orthogeriatric Service

The foundation of an effective evidence-based hip fracture service is orthogeriatric care. Orthogeriatric care is a medical-surgical model which brings together multidisciplinary health professionals from trauma, orthopaedics and geriatric medicine to treat the fracture and frailty issues affecting people with hip fractures. Compared to the traditional approach of orthopaedic ownership with ad-hoc medical input, orthogeriatric care has consistently delivered better outcomes, such as improved survival, recovery of function and reduced likelihood of requiring institutionalised care. This has led to many countries and national guidelines adopting such a care model. However, many places still do not have orthogeriatric services. In this chapter, we lay down the principal steps required to establish such a service. These steps include mapping the local hip fracture pathway, in order to identify key multidisciplinary team members, determine resources required, recognise sustainability factors, utilise clinical audit and embrace support from external organisations. These steps are not meant to be prescriptive but aim to provide the framework required to develop an orthogeriatric service.