Brigham Fracture Intervention Team Initiatives for Hospital Patients with Hip Fractures A Paradigm Shift英文文献资料.docVIP
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Brigham Fracture Intervention Team Initiatives for Hospital Patients with Hip Fractures A Paradigm Shift英文文献资料
HindawiPublishingCorporation
InternationalJournalofEndocrinology
Volume2010,ArticleID590751,7pages
doi:10.1155/2010/590751
ResearchArticle
BrighamFractureInterventionTeamInitiativesforHospital
PatientswithHipFractures:AParadigmShift
JulieGlowacki,MitchelB.Harris,JosefSimon,JohnWright,NikheelS.Kolatkar,
ThomasS.Thornhill,andMerylS.LeBoff
DepartmentsofOrthopedicSurgeryandMedicine,BrighamandWomen’sHospital,75FrancisStreet,Boston,MA02115,USA
CorrespondenceshouldbeaddressedtoJulieGlowacki,jglowacki@
Received14April2009;Accepted5July2009
AcademicEditor:DianeKamen
Copyright?2010JulieGlowackietal.ThisisanopenaccessarticledistributedundertheCreativeCommonsAttributionLicense,
whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperlycited.
Wedesigned,implemented,andrevisedtheBrighamFractureInterventionTeam(B-FIT)initiativestoimprovein-hospitalcare
offracture(Fx)patients.E?ectivenesswasevaluatedfor181medicalrecordsof4cohortsinfoursuccessiveyearsofconsecutive
patientswhowereadmittedwithafragilityhipFx.TheDischargeInitiative(DI)(computer-based)includes1200mgcalcium
and1000IUvitaminD3 daily.TheAdmissionInitiative(AI)wasintroducedoneyearlaterwithremindersforserum25OHD
measurement,initiationofdailycalcium(1200mg)andvitaminD(800IU),andanorderforEndocrinologyconsultation,with
anamendmentforacomputer-assistedreminderandadoseofD2(50000IU).Initially,thecomputer-basedDIwasmoree?ective
(67%)thanthesurgeon-drivenAI(33%,P.001).Afterintroductionofacomputer-assistedreminder,AIe?ectivenessincreased
to68%.ThemarkedprevalenceofvitaminDinsu?ciencyrea?rmstheimportanceofincorporatingvitaminDrecommendations
inFxcarepathways.
1.Introduction
This study evaluates the e?ectiveness of the Brigham
Fracture Intervention Team (B-FIT) initiatives, new in-
hospital care initiatives designed to address osteoporosis
evaluation and in-hospital management. These care path-
ways include a Discharge Initiative and several versions
of Admissions Initiatives. Because of o
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