Time from admission to surgery in Polish patients with hip fractures : temporal trends in the last decade and association with duration of hospitalization and in-hospital mortality

Introduction: Hip fracture is an important cause of morbidity and mortality among elderly patients worldwide. It poses a particular challenge for healthcare systems with limited financial and human resources. Objectives: The aim of the study was to assess factors associated with the length of hospital stay and in-hospital mortality, focusing on the time from admission to surgery. The secondary goal was to assess temporal trends in the intervals of admission to surgery between 2010 and 2011 and in 2019. Patients and methods: This was a cross-sectional study enrolling patients aged 65 years or older who underwent surgery for hip fracture between January 2010 and October 2011 in 12 Polish hospitals. Demographic and clinical data, dates of hospital admission and surgery as well as information about in-hospital death were gathered. We additionally searched the databases of the same 12 hospitals for patients hospitalized due to hip fracture between January and June 2019 and recorded the dates of admission and surgery. Results: We included 381 patients who underwent surgery in 2010 and 2011 and 761 patients hospitalized in 2019. In a multivariable analysis, including age, sex, and diagnosis of dementia, we observed association between time from admission to surgery and higher in-hospital mortality and longer hospital stay. There was a decrease in proportion of patients undergoing surgery within 2 days from admission (52.8% vs 44.3%; P = 0.007) between 2010 to 2011 and in 2019. Conclusions: In-hospital mortality and length of hospitalization were associated with time from admission to surgery in patients undergoing surgery for hip fracture. We observed an alarming trend towards an increase in the admission–surgery interval

Is having quality as an item on the executive board agenda associated with the implementation of quality management systems in European hospitals: a quantitative analysis.

OBJECTIVE: To assess whether there is a relationship between having quality as an item on the board's agenda, perceived external pressure (PEP) and the implementation of quality management in European hospitals. DESIGN: A quantitative, mixed method, cross-sectional study in seven European countries in 2011 surveying CEOs and quality managers and data from onsite audits. PARTICIPANTS: One hundred and fifty-five CEOs and 155 quality managers. SETTING: One hundred and fifty-five randomly selected acute care hospitals in seven European countries (Czech Republic, France, Germany, Poland, Portugal, Spain and Turkey). Main outcome measure(s) Three constructs reflecting quality management based on questionnaire and audit data: (i) Quality Management System Index, (ii) Quality Management Compliance Index and (iii) Clinical Quality Implementation Index. The main predictor was whether quality performance was on the executive board's agenda. RESULTS: Discussing quality performance at executive board meetings more often was associated with a higher quality management system score (regression coefficient b = 2.53; SE = 1.16; P = 0.030). We found a trend in the associations of discussing quality performance with quality compliance and clinical quality implementation. PEP did not modify these relationships. CONCLUSIONS: Having quality as an item on the executive board's agenda allows them to review and discuss quality performance more often in order to improve their hospital's quality management. Generally, and as this study found, having quality on the executive board's agenda matters