The Australian Commission on Safety and Quality in Health Care has unveiled an updated national clinical care standard for hip fractures. This revised standard reduces the recommended maximum time for surgery to 36 hours, down from 48 hours, aligning with international guidelines and covering patients who may need to be transferred for surgery.

Each year, about 19,000 Australians, mostly over 65 years old, suffer hip fractures, often leading to life-altering consequences. Hip fractures increase the risk of death, with one in four patients not surviving a year post-injury. Many survivors lose their independence and quality of life.

The updated standard aims to address these issues by emphasizing the need for prompt surgery, reducing pain, and facilitating recovery. It recognizes the vulnerability of older patients and the importance of timely intervention. The financial burden on the healthcare system, approximately $600 million annually, also highlights the urgency of improving hip fracture care.

While progress has been made since the introduction of the Hip Fracture Clinical Care Standard in 2016, there is still significant variation in surgery wait times, with some hospitals performing well below the recommended 36-hour threshold. The updated standard is expected to serve as a catalyst for change, setting expectations for consistent, high-quality hip fracture care and encouraging tailored treatments for individual patients.

“The Hip Fracture Clinical Care Standard sets expectations for how every patient should be cared for, while allowing for treatment to be tailored to the individual,” said Professor Jacqueline Close, Co-Chair of the ANZHFR and Co-Chair of the expert advisory group for the standard. She believes that the updated standard will be a lever of change to improve the care for hip fracture patients in Australia and thus improve the patient’s lives.

At FFN, we are pleased to announce the launch of this new Clinical Standard in Australia. Read more about this announcement here: https://www.safetyandquality.gov.au/newsroom/latest-news/time-surgery-critical-survival-after-hip-fracture

Click the link to access the new clinical standard https://www.safetyandquality.gov.au/standards/clinical-care-standards/hip-fracture-care-clinical-care-standard

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Evaluating a hip fracture patient’s performance in the early phase of recovery (2 months after a fracture) improves prediction of impaired 12-month walking ability.

Walking ability indicates the level of functional recovery and independent living in patients with a hip fracture. Almost half of the older hip fracture patients who were able to walk before the fracture event can’t walk a block without assistance 1 year post hip fracture.

 
This study undertaken in USA explored the association between the assessment of physical performance early in the recovery period of 162 hip fracture patients and their 12-month post-fracture mobility.

SPPB score and 3-meter gait speed, two easily and quickly observed measures of functional performance, can provide important information regarding the ability to walk 1 block, an indicator of functional ability, at 12 months after a hip fracture. According to the study, these measures ‘not only predict gradual decline but also gradual recovery’ after a hip fracture.

Furthermore, other predictive factors of greater risk of mobility limitation at 12-months after a hip fracture were age, ability to walk 1 block pre-fracture and ability to walk 10 feet at 2 months post-fracture.

Dr Jay Magaziner, one of the authors, stated: "There are a number of reliable and objective tools that can assess the patient's functional recovery. These can be used by different health care professionals and will provide information that can optimize planning for the recovery of long-term mobility."

Read the article here!

We are pleased to share the paper entitled "Standardization of global hip fracture audit could facilitate learning, improve quality, and guide evidence-based practice, an international study of hip fracture registries in 20 countries using the Fragility Fracture Network 2022 Minimum Common Dataset". The paper is about assessing compatibility of existing registries with the Fragility Fracture Network 2022 Minimum Common Dataset. It was published in The Bone and Joint Journal on 1 September 2023. 

We hope you enjoy the article and please share with colleagues who are interested in audits. We thank everyone within the Hip Fracture Audit Special Interest Group who was involved for their excellent work.

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