The data presented in this content is described as “sobering” and is shown to have a significant impact on individuals, families, and the healthcare system. It burdens the health system with $600 million annually.
To address this issue, the maximum time to hip fracture surgery has been reduced from 48 hours to 36 hours. This decision was made after a health care commission discovered that one in four older people died within 12 months of a hip injury, indicating a higher risk of death.
The Australian Commission on Safety and Quality in Health Care (ACSQHC) launched the updated national Hip Fracture Clinical Care Standard at the binational Hip Fest 2023 conference. This updated standard includes improved care management statements and is expected to drive meaningful improvement as hospitals implement protocols to meet them.
ACSQHC Acting Chief Medical Officer Carolyn Hullick emphasized the urgent need for better care in health services. She acknowledged that a hip fracture is more than a broken bone, as it significantly impacts the wellbeing of older, frail, and vulnerable individuals. Repairing the fracture quickly is crucial to reduce pain and facilitate recovery and independence.
Data from ACSQHC shows that 19,000 people fracture their hip annually in Australia, primarily due to falls. Hip fractures predominantly affect people over the age of 65 and often result in a loss of independence or the inability to return to their previous lifestyle.
The immense personal toll of hip fractures on individuals and families, along with the financial burden on the health system, highlights the need for urgent action.
The Australian health system faces additional challenges, including an aging population and increasing demand for hip services. The Department of Health and Aged Care (DHAC) suggests that a flexible and well-trained workforce is necessary nationwide to meet the demands of the older population.
Furthermore, ACSQHC found variations in the time-to-surgery across the country, with many people waiting longer than optimal for their hip fracture surgery. However, some hospitals have made significant reductions in wait times.
The updated time for hip fracture surgery now takes into account the need for patient transfers to hospitals that can perform the surgery. ANZHFR Co-chair Jacqueline Close believes this change will drive improvements in patient outcomes, as waiting for surgery can be associated with complications and delayed recovery.
Evidence shows that patients who return home quickly after surgery experience improved functional recovery. However, in 2022, less than half of the patients walked on the first day after surgery, indicating room for improvement.
The updated Hip Fracture Clinical Care Standard outlines improvements in care based on an orthogeriatric model of care. This model involves collaboration between orthopedic surgeons and geriatric medicine specialists to address the complex needs of older individuals, including malnutrition, frailty, cognitive impairment, and delirium.
Hospitals have been focusing on implementing the orthogeriatric model of care since the introduction of the Hip Fracture Clinical Care Standard in 2016. This model has been shown to improve mortality, complications, functional outcomes, medication management, and cost-effectiveness.
ACSQHC believes that the updated standard will continue to drive improvement in care and patient outcomes. The goal is to see these changes implemented effectively in hospitals, resulting in significant positive impacts on patients’ lives.