Hip Fracture Clinical Care Standard
The Hip Fracture Clinical Care Standard (2023) provides guidance to clinicians and health services on delivering appropriate care for people with a hip fracture.
The updated standard was launched on Monday 11 September at the ANZHFR Hip Fest conference.
Download the updated Standard
The updated Hip Fracture Clinical Care Standard was released on 11 September 2023 at the ANZHFR Hip Fest conference, following a review of current evidence and consultation with clinical experts and key organisations. The standard was first published in 2016.
The goal of the Hip Fracture Clinical Care Standard is to improve the assessment and management of people with a hip fracture in order to optimise outcomes and reduce their risk of another fracture.
Launch of the revised standard
The updated Hip Fracture Clinical Care Standard was launched at the Australian and New Zealand Hip Fracture Registry (ANZHFR) Hip Fest 2023, on Monday 11 September 2023, by Conjoint Associate Professor Carolyn Hullick, Acting Chief Medical Officer.
Watch the recording of launch below.
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Contents of the standard and resources
- For consumers, the Standard describes the care you should expect to receive if you have a hip fracture. Find out more about what the Standard means for consumers and the information available.
- For clinicians, the Standard provides guidance on the seven evidence-based quality statements. Find out more about what the standard means for clinicians.
- For healthcare services, the Standard describes key components of care that health services can use to guide practice and monitor improvements in care. Find out more about implementing the Standard and other information for healthcare services.
What changes have been made in the updated standard?
Changes have been made to align the quality statements and indicators with the evidence base and current practice. Key updates in the current version include:
- The addition of cultural safety and equity considerations
- Changes to
- Quality statements 1 and 3 - to include assessment and management of delirium, nutrition and frailty
- Quality statement 2 - to include the use of nerve blocks, and to align with the care described in the Opioid Analgesic Stewardship in Acute Pain Clinical Care Standard
- Quality statement 4 - to reduce the time to surgery from 48 hours to 36 hours
- Amendments to the indicators, including new, retired and changed indicators.
Can I still use the existing standard?
The revised clinical care standard maintains the same scope and goal of the 2016 Hip Fracture Clinical Care Standard. It is recommended that services starting to implement the Hip Fracture Clinical Care Standard use the 2023 version. Services currently using the 2016 Hip Fracture Clinical Care Standard should transition to the new standard as soon as possible, no later than within 12 months from release of the updated Standard (by September 2024).
A hip fracture is a break occurring at the top of the thigh bone (femur), near the pelvis. Hip fracture is an event that often signifies underlying ill health. Most hip fractures occur in people aged 65 years and over, with an average age of 82 years across Australia and New Zealand Aotearoa. Individuals with hip fracture are over 3.5 times more likely to die within 12 months compared to non-injured individuals. This patient group also has a high hospital-acquired complication rate, resulting in patient suffering and unnecessarily high healthcare costs.
Key markers of quality of care in hip fracture such as time to surgery, complication rates, hospital readmission rates and length of stay can vary considerably between hospitals. Hip fracture patients, being vulnerable due to their age, are at risk of other common hospital-acquired complications such as those defined by the Commission. The quality of care is influenced by, among other factors, the configuration of orthopaedic and geriatric medicine services, hospital protocols and processes, and the degree to which a multidisciplinary approach to care is taken.
These considerations were fundamental to the development of the Hip Fracture Clinical Care Standard.
Consultation and endorsement
The process for revising the Standard has included consultation with the Hip Fracture Clinical Care Standard Topic Working Group, a targeted consultation process with potential endorsing organisations and internal review through the Commission’s processes.
The Standard has been endorsed by a number of key organisations.
Further information is available on the evidence base which underpins the Hip Fracture Clinical Care Standard.
Evaluating the impact of the Hip Fracture Clinical Care Standard
As part of the review, an evaluation of the Hip Fracture Clinical Care Standard was undertaken in 2020. The evaluation found that:
- 98% of respondents reported that the Hip Fracture Clinical Care Standard improved care when implemented by their organisation
- 96% of respondents reported that the Hip Fracture Clinical Care Standard was relevant to their practice.
Read more about how the Hip Fracture Clinical Care Standard is improving care in the evaluation report.
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