Indicators - Hip Fracture Clinical Care Standard

While this clinical care standard does not include indicators specific to measuring patient experiences, the Commission strongly encourages healthcare services to use the Australian Hospital Patient Experience Question Set (AHPEQS). AHPEQS is a 12-question generic patient experience survey that has been validated in both day-only and admitted hospital patients across many clinical settings. The instrument is available for download to both private and public sector healthcare services.

In Australia, patient-reported outcome measures (PROMs) are an emerging method of assessing the quality of health care. The Commission is leading a national work program to support the consistent and routine use of PROMs to drive quality improvement.

PROMs are standardised, validated questionnaires that patients complete, without any input from healthcare providers. They are often administered at least twice to an individual patient – at baseline and again after an intervention, or at regular intervals during a chronic illness. The information contributed by patients filling out PROMs questionnaires can be used to support and monitor the movement of health systems towards person-centred, value-based health care.

PROMs are being used to evaluate healthcare effectiveness at different levels of the health system, from the individual level to service and system levels. There is growing interest across Australia and internationally in the routine interrogation of patient-reported outcome information for evaluation and decision-making activities at levels of the health system beyond the clinical consultation.

• Indicator 1b (now 1a) on screening for cognitive impairment to align with Indicator 1b of the Delirium Clinical Care Standard

• Indicators 2b and 2c on the proportion of patients receiving a nerve block prior to surgery and prior to transfer from another hospital, where applicable
• Indicators 3a and 3b on assessing for clinical frailty and delirium
• Indicator 3c on the proportion of patients receiving protein and energy oral nutritional supplements

• Indicator 1a ‘Evidence of local arrangements for the management of patients with hip fracture in the emergency department’
• Indicator 2a ‘Evidence of local arrangements for timely and effective pain management for hip fracture’
• Indicator 3a ‘Evidence of orthogeriatric (or alternative physician or medical practitioner) management during an admitted patient’s hip fracture episode of care’
• Indicator 5b ‘Proportion of patients with a hip fracture with unrestricted weight bearing status immediately post hip fracture surgery’
• Indicator 5d ‘Proportion of patients with a hip fracture returning to pre-fracture mobility’
• Indicator 6b ‘Proportion of patients with a hip fracture readmitted to hospital with another femoral fracture within 12 months of admission from initial hip fracture’
• Indicator 7b ‘Proportion of patients with a hip fracture living in a private residence prior to their hip fracture returning to private residence within 120 days post separation from hospital’.