Hip Fracture Clinical Care Standard 2023
Indicator Set Attributes
Identifying and definitional attributes | |
Metadata item type: | Indicator Set |
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Indicator set type: | Other |
METEOR identifier: | 780812 |
Registration status: | Australian Commission on Safety and Quality in Health Care, Standard 10/09/2023 |
Description: | The Australian Commission on Safety and Quality in Health Care has developed these indicators to support health service organisations to monitor implementation of the care described in the Hip Fracture Clinical Care Standard (ACSQHC 2023). The indicators included in this specification are a tool to support local clinical quality improvement and may be used to support other quality assurance and peer review activities. The goal of the standard is to:
The clinical care standard relates to the care that people with a suspected hip fracture should be offered from presentation to hospital through to completion of treatment and discharge from hospital. This also includes people who sustain a hip fracture while in hospital. The target age for the clinical care standard is 50 years and older but is also appropriate for people aged under 50 years with a suspected hip fracture judged to be due to osteoporosis or osteopenia. A clinical care standard contains a small number of quality statements that describe the clinical care expected for a specific clinical condition or procedure. Indicators are included for some quality statements to help health service organisations monitor how well they are implementing the care recommended in the clinical care standard. The quality statements included in the Hip Fracture Clinical Care Standard are as follows: 1. Care at presentation. A person presenting to hospital with a suspected hip fracture receives care that is guided by timely assessment and management of medical conditions, including cognition, pain, nutritional status and frailty. Arrangements are made according to a locally endorsed hip fracture pathway. 2. Pain management. A person with a hip fracture is assessed for pain at the time of presentation to the emergency department and regularly throughout their acute admission. Pain management includes appropriate multimodal analgesia and nerve blocks, unless contraindicated. 3. Orthogeriatric model of care. A person with a hip fracture is offered treatment based on an orthogeriatric model of care as defined in the Australian and New Zealand Guideline for Hip Fracture Care.1 A coordinated multidisciplinary approach is used to identify and address malnutrition, frailty, cognitive impairment and delirium. 4. Timing of surgery. A person with a hip fracture receives surgery within 36 hours of their first presentation to hospital. 5. Mobilisation and weight bearing. A person with a hip fracture is mobilised without restrictions on weight bearing starting the day of, or day after, surgery, and at least once a day thereafter, according to their clinical condition and agreed goals of care. 6. Minimising risk of another fracture. Before a person leaves hospital after a hip fracture, they receive a falls and bone health assessment and management plan, with appropriate referral for secondary fracture prevention. 7. Transition from hospital care. Before a person leaves hospital after a hip fracture, an individualised care plan is developed that describes their goals of care and ongoing care needs. This plan is developed in discussion with the person and their family or support people. The plan includes mobilisation activities and expected function post-injury, wound care, pain management, nutrition, fracture prevention strategies, changed or new medicines and specific rehabilitation services and equipment. On discharge, the plan is provided to the person and communicated with their general practice and other ongoing clinicians and care providers. |