Leveraging a Learning Health System Approach to Integrate Care for Patients with a Hip Fracture: a real life story set in a large hospital

Background: A Learning Health System approach can provide structure and tools to blend insights from research and real-world health care operations to support implementation and delivery of integrated care. Our team has put this into practice in a large community hospital with the aim of improving the overall effectiveness of care delivery and outcomes for patients with a hip fracture.A Learning Health System is a health care ecosystem that continuously learns and improves by blending insights from research (or quality improvement) and health care operations. By collecting and analyzing data (numbers experiences) from heath care operations, guided by scientific evidence and research methods, it generates new knowledge to ensure that insights from the real-world and scientific evidence are used to inform care delivery, drive innovation, and improve health outcomes. It lends itself exceptionally well to support the implementation and delivery of integrated care - a healthcare delivery approach that seeks to coordinate all aspects of healthcare services around the patient's needs.We present a real-life application of a Learning Health System approach to integrate the care for patients with a hip fracture along their care trajectory through the hospital. The Learning Health System action framework as presented by Reid and colleagues (2024) includes 5 learning gears that can be applied individually or together to support, among many applications, the implementation and delivery of integrated care. The framework presents the following learning gears: . Advanced Analytics Population Insight, 2. Evidence Synthesis Curation, 3. Patient, Caregiver Provider Co-design, 4. Implementation Reach, 5. Rapid Cycle Evaluation, Feedback Adaptation.

Approach: Our hospital cares for around 500 patients with a hip fracture per year. To improve quality of care, ensure timely access to surgery and timely and effective transitions along the care trajectory, a Hip Fracture Care Transformation project team was formed. This group consists of a wide variety of stakeholders from various departments and layers of the hospital. This group applies the Learning Health System approach to create integrated care solutions with the aim of ensuring that patients are receiving the care they need at the right time and in the most appropriate place. We will present our work on several interventions including the introduction of a Hip Alert in the Emergency Department whereby several specialists are notified of a patient with a hip fracture concurrently instead of in a sequential manner. Furthermore, we will present the work on the co-design of the integrated care delivery of a Mobile Nerve Block Service to support a multi-modal pain management strategy and opioid sparing approach early in the patient trajectory and at any location the patient is in. Lastly, we will present our work on creating a dashboard to monitor drivers of surgical delays as well as the co-design of interventions to improve the efficiency of the care delivery to reduce time to surgery.Implication Our presentation will give insights into a Learning Health System approach and how it can be leveraged to inform the implementation and delivery of integrated care. We will draw from both the evidence as well as our real live experiences.. Reid RJ, Wodchis WP, Kuluski K, Lee-Foon NK, k Lavis JN, Rosella LC, Desveaux L. Actioning the Learning Health System: An applied framework for integrating research into health systems. SSM - Health Systems. 2024;2:0000. https://doi.org/0.06/j.ssmhs.2024.0000