Brigham fracture intervention team initiatives for hospital patients with hip fractures: A paradigm shift

Abstract

We designed, implemented, and revised the Brigham Fracture Intervention Team (B-FIT) initiatives to improve in-hospital care of fracture (Fx) patients. Effectiveness was evaluated for 181 medical records of 4 cohorts in four successive years of consecutive patients who were admitted with a fragility hip Fx. The Discharge Initiative (DI) (computer-based) includes 1200mg calcium and 1000IU vitamin D3 daily. The Admission Initiative (AI) was introduced one year later with reminders for serum 25OHD measurement, initiation of daily calcium (1200mg) and vitamin D (800IU), and an order for Endocrinology consultation, with an amendment for a computer-assisted reminder and a dose of D2 (50 000IU). Initially, the computer-based DI was more effective (67%) than the surgeon-driven AI (33%, P