Education greatly improves AMT scoring

Published Date: 19th July 2016

Publication Authors: Gudena R, Allsup S

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Introduction

The best practice tariff (BPT) for fragility hip fracture applies to patients aged 60 years and over admitted with a fractured neck of femur (NOF). It awards 1335 per case provided several criteria are met including completion of pre and post-operative abbreviated mental test (AMT). Our fractured NOF pathway prompted AMTscoring, but was often ignored. This audit aimed to improve BPT compliance and patient care.

Methods

A retrospective case-note review was undertaken demonstrating poor compliance. Education about AMT is now included in the induction for new junior doctors and this was discussed at several departmental meetings to increase awareness. A series of retrospective reaudits were undertaken to assess for improvement.

Results

In 92 patients admitted with fractured NOF between September- November 2011, 21% of admissions were AMT compliant (37% completed pre-operatively, 65% post-operatively). Re-audit of 131 cases from August- November 2012 showed 53% compliance (86% pre-operatively, 62% postoperatively). Further re-audit of 82 patients from April-June 2013 revealed 88% compliance (100% pre-operatively, 88% post-operatively).

Conclusions

Educating doctors and the wider multidisciplinary team greatly improved AMT scoring. This improved care by quickly identifying delirium and dementia to expedite investigation. Similar education should be arranged in trusts underachieving AMT documentation.

Davies, P; Hughes, D; Heseltine, T; Allsup, S; Gudena, R. (2014).  Education greatly improves AMT scoring in patients with fractured neck of femur . International Journal of Surgery. 12 (Supple 3), S58-S59.

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