Hip fracture is a common serious injury, which occurs predominately in the elderly. The care of hip fracture is multidisciplinary and resources vary across the country. The Scottish Hip Fracture Audit (SHFA) (see contacts for current Steering Group and subgroups) aims to improve hip fracture care by providing robust nationally comparable data on the care of hip fracture patients (see Objectives).
The audit started in 1993 in four hospitals, funded by the Clinical Resource Audit Group (CRAG). Since March 1999, the Information Services Division (ISD) of NHS National Services Scotland have met central co-ordinating costs. Whilst data collection has historically been funded locally, temporary Scottish Government funding allowed full coverage of mainland hip-fracture operating hospitals in 2007 and 2008. New data collection stopped in December 2008 when the resource was transferred to an audit of Musculoskeletal Access (MSK).
In 2004, following a comprehensive standardisation and validation of local hospital databases, SHFA developed a single national database of audited hip fractures, ultimately incorporating data from all mainland Scotland hip fracture operating hospitals. We also re-launched data collection proformas and instructions, standardised across the country, and provided non-participating hospitals with temporary audit staffing to achieve full national coverage for the first time. This national database, now updated to 2008, provides a valuable tool for audit, management and research of this frail and vulnerable group of patients.
SHFA included all patients aged 50 or over who sustained a hip fracture, regardless of pathology or mechanism of injury. A standard core dataset was collected during the patient's acute stay, and at four months post-acute admission. The four-month review data was predominately collected by telephone to patients or their carers, although standardised postal questionnaires were used when necessary.
Data was collected on-site by dedicated Local Audit Co-ordinators, who submitted each hospital’s data to a central ISD team comprising a Clinical Co-ordinator, a Statistician and a Data Co-ordinator (see Contacts for more details). The SHFA collected complete and accurate data, using standardised data collection proformas and procedures (see proformas), sub-contracted dual data entry and thorough electronic validation processes.