Improve the patient journey and prepare now for rising hip fracture rates

With the number of hip fracture cases projected to rise, Sentara Healthcare wanted to rethink its care pathway—from the emergency department to physician clinics to physical therapy—to create long-term, sustainable change.


Sentara tracked patients across sites to understand their patient journey, including interviews across 12 hospitals. Hospital leaders took steps to prepare for a rise in hip and femur fractures, as shown in the Sg2 2022 Impact of Change® forecast.

Note: Analysis excludes 0-17 age group and includes the Hip and Femur Fracture CARE Family only. Inpatient forecast indicates discharges; outpatient forecast indicates volumes. Medical admissions includes no procedure, diagnostics and minor therapeutics discharges. Forecast: ED visits include emergent and urgent visits procedure groups. ED visits may include transfer volumes and exclude volumes subsequently admitted to IP. Home health includes home nurse visits, home hospice visits, home other visits, home E&M and home PT/OT, OP, PT/OT excludes home PT/OT and includes evaluations and follow-up PT/OT visits. Imaging includes advanced imaging and standard imaging procedure groups. E&M = evaluation and management. SNF = skilled nursing facility. Sources: Impact of Change®. 2022 HCUP National Impatient Sample (NIS) Healthcare. The following 2019 CMS Limited Data Sets (LDS): Carrier, Denominator, Home Health Agency, Hospice, Outpatient, Skilled Nursing Facility. Claritas Pop-Facts®. 2022; Sg2 Analytics. 2022.


Improve the patient journey and prepare now for rising hip fracture rates


Built on a mindset of continuous improvement 

Vizient provided the clinical expertise to support the new pathway, which was built to serve four primary goals:

  • Get the patient into surgery as quickly as possible
  • Focus on early mobility and ambulation
  • Reduce dependence on opioids
  • Discharge patients to the appropriate care setting

Sentara Healthcare has improved care coordination and patient outcomes for geriatric patients with low energy hip fractures as a result as well as optimized facility-related processes and capacity management.

“From the onset, we were able to involve the right people with the right information to move our project goals forward. Ensuring clinical support from every department delivering care to hip fracture patients was critical to our success.”

Tyler Bennett, MHA, System Director, Orthopedic Service Line
Sentara Healthcare

Improvements in care quality and patient outcomes as a result


length of stay ratio
in 2021Q1
compared to 1.09
in 2018Q4


discharge to home rate
in 2021Q4
compared to 19.71%
in 2018Q4


mortality ratio
in 2021Q1
compared to 1.03
in 2018Q4


urinary tract infection rate
in 2021Q1
compared to 5.35%
in 2018Q4

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