Hip Fracture Minimum Standards

NSW Health recognises the challenges in managing older people who suffer a hip fracture.  Following on from several ACI, CEC and BHI reports, the ACI developed the Minimum Standards for the Management of Hip Fracture in the Older Person to assist hospitals to identify key components of best practice management for fractured neck of femur that will support optimal patient care across NSW.

A key goal of the Minimum Standards is to use a multidisciplinary team approach to reduce variation in patient outcomes including in the areas of avoidable medical complications, prolonged hospitalisation and poorer patient outcomes.  Successful implementation of the standards requires a collaborative multidisciplinary team approach to care and patients are often elderly, frail and have multiple medical problems. The ACI is partnering with hospitals in LHDs across NSW to support implementation of the Minimum Standards.

Formative evaluation

The ACI has completed a formative evaluation of implementation of the Minimum Standards.  The objectives were to:

• measure  early impacts.
• identify barriers and success factors for implementation.
• determine the level of clinician acceptance of the Standards.
• identify areas for improvement in the tools.

The six hospitals selected to be part of the formative evaluation were Prince of Wales, Concord, Royal North Shore, Wagga Wagga, Port Macquarie and Gosford.  These hospitals undertake approximately 20% of hip fracture surgery in NSW.

Major findings from the formative evaluation

• strong clinician support
• reduction in mortality for patients receiving surgery within 48 hrs
• increase in the number of patients receiving surgery within 48 hrs
• reduction in length of stay
• reduction in overall time to surgery
• positive experience form the staff perspective
• improvement in all hospital results
• positive experiences with the STARs Hip Fracture Reporting software

Given these positive early results and identified areas for further work, the ACI will continue to support LHDs to achieve best practice in hip fracture care.  The formative evaluation report will shortly be available.

Visit the Minimum Standards for the Management of Hip Fractures page for videos and resources or use the links below.