Improving inpatient care with the introduction of a hip fracture pathway.

A system of payment by results exists for the management of hip fractures in England and Wales. Poor performance against the national standards was noted, reflecting failure to deliver optimal care. Through the introduction of a multi-disciplinary patient pathway and clerking pro forma, the proportion of patients earning the best practice tariff uplift increased from 44.4% to 91.7%. This demonstrates a significant improvement in patient care measured against the guidelines, also resulting in a substantial revenue increase for the department.