Hip Fracture

Hip fracture is a common, serious injury. However, hip fracture patients often face delays transitioning from acute care to rehabilitation—contributing to poorer outcomes and significant ALC pressures within acute care.

The GTA Rehab Network is leading an initiative to increase timely access to post-acute rehabilitation for hip fracture patients, that includes the following components:

• Updated clinical care guidelines: These guidelines for hip fracture patients in acute care and rehabilitation settings incorporate the latest information from Osteoporosis Canada as well as screening tools, protocols and educational materials used by hospitals. They support the care of hip fracture patients while in hospital as well as the smooth and early transition of patients to inpatient rehabilitation.

• Data sharing for benchmarking: The Network analyzes and disseminates quarterly, organization-specific data on hip fracture patients. Data elements include time to surgery, length of stay, ALC days and discharge destination, among others. Hospitals are measuring their performance against the benchmark and each other and performance is improving.

• Increasing capacity: A Network-led review of system-wide performance for hip and knee replacements identified the potential to rebalance MSK rehabilitation resources across rehabilitation hospitals. This would create additional inpatient capacity for hip fracture patients. Toronto Central LHIN has established an MSK Implementation Group to move the Network’s recommendations forward.

• Defining costs: The Network is working with decision support representatives from case costing hospitals to define the costs of treating hip fracture patients relative to joint replacement patients to help illustrate the resource implications of the proposed system changes.