Introduction. Hip fractures are common injuries in the older persons, with significant associated morbidity and mortality. The Irish Hip Fracture Database (IHFD) was implemented to monitor standards of care against international standards. Methods. The IHFD is a clinically led web-based audit. We summarize the data collected on hip fractures from April 2012 to March 2013 from 8 centres. Results. There were 843 patients with the majority being (70%) female. The 80–89-year age group accounted for the majority of fractures (44%). Most (71%) sustained a fall at home. Intertrochanteric fractures (40%) were most common. Only 28% were admitted to an orthopaedic ward within 4 hours. The majority (97%) underwent surgery with 44% having surgery within 36 hours. Medical optimization (35%) and lack of theatre space (26%) accounted for most of the surgical delay. While 29% were discharged home, 33% were discharged to a nursing home or other long-stay facilities. There was a 4% in-hospital mortality rate. Conclusions. Several key areas in both the database and aspects of patient care needing improvement have been highlighted. The implementation of similar databases has led to improved hip fracture care in other countries and we believe this can be replicated in Ireland. 1. Introduction The Irish Hip Fracture Database (IHFD), the first of its kind in Ireland, is a national clinical audit developed to improve hip fracture care and outcomes in Ireland. Through the synergy of audit, clinical standards, and feedback it aims to provide a nationwide platform upon which each individual service can effectively measure, compare, and ultimately improve its service provision. In 2008, a national report on falls and fracture in Ireland’s ageing population identified hip fractures as one of the most serious injuries due to a fall, resulting in lengthy hospital admissions, ongoing care in step-down facilities, and ultimately a high cost to the health service [1]. The rate of hip fracture in the total population aged 50 and over was 407 for females and 140 for males per 100,000 [2]. Furthermore, hip fractures account for half of all fractures in patients over the age of 65 [3]. With approximately 3,000 people sustaining hip fractures on an annual basis in Ireland, a figure which will inevitably increase given our ageing population, hip fractures, and the management thereof presents a significant challenge for both geriatricians and orthopaedic surgeons alike. The implementation of a hip fracture database has been shown to improve the quality of care of hip fracture patients in other
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