Evaluation of a rib fracture management pathway in an Australian tertiary trauma hospital.

ObjectiveRib fractures are a common cause of hospitalisation in the adult trauma population and are associated with significant morbidity and mortality. This study aimed to assess the efficacy of a bundle of care known as the 'rib fracture pathway' in improving patient-centred outcomes and health economic outcomes in an Australian tertiary trauma hospital.MethodsThis single-centre retrospective cohort study analysed prospectively collected pain registry data from 2004 to 2022, encompassing the period before and after the implementation of the rib fracture pathway.ResultsThe implementation of a rib fracture pathway was not associated with a reduction in patient reported pain scores at rest or on movement. Post-implementation, patients were more likely to receive a regional nerve block (56.7% vs. 10.4%, p < 0.001). Despite this, length of hospital stay was increased post-implementation (8.9 vs. 8.1 days, p = 0.01), and duration of Acute Pain Service follow-up increased (3.8 vs. 3.0 days, p < 0.001). The lengthier hospital stay persisted in patients with >2 rib fractures (8 vs. 7 days, p = 0.01).ConclusionsThis study demonstrates that the implementation of a rib fracture pathway was not associated with clear improvements in patient-centred outcomes and was associated with adverse health economic outcomes, including increased length of hospital stay.