Proximal femoral fractures affect around 60 000 patients annually in the UK. A delay in excess of 48 hours from admission to theatre has been shown to have an adverse effect on mortality, morbidity and length of inpatient stay in this patient group (Hollingworth 1993). We set out to identify the causes and effects of any delay to theatre and make suggestions in order to improve the quality and efficiency of our service.

We tracked 224 consecutive patients all admitted with a proximal femoral fracture over an eight month period. We recorded a number of details including whether or not a delay occurred and why, on a session-by-session basis.

Of the 214 patients included, 75.7% were considered fit enough for surgery at admission; 83.2% of these suffered some sort of delay to theatre. Only 5.6% of patients (8 in total) were considered fit enough for surgery at admission, suffered a delay to theatre and subsequently became unfit causing a further delay.

We were reassured to find that our patients are not suffering a longer than average delay to theatre and that those patients who were waiting longer were not becoming ill as a result. We also found that patients admitted on certain days of the week seemed to wait longer, indicating that certain sub-specialty elective lists were taking up theatre time and exacerbating the delay. We have suggested changes to the theatre rota in order to maximise efficiency and aim to repeat this audit to evaluate the effect of these changes.