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Technology and health care for the elderly medical research studies

Focus on strategic priorities that have significant social impact.

KS 2013-07

Hip fracture quality indicators: A scoping review

This study highlights the need for the development of important and feasible quality of care indicators for hip fracture patients within the post-acute care period.

Research Results

Findings: Titles and abstracts of 2,053 articles were screened. The full text of 495 articles was then screened for inclusion, of which only 201 were deemed relevant for data extraction. Only 19 studies were Canadian, with most studies from the United Kingdom (n=46) or the United States (n=37). Most quality of care indicators were developed and used to evaluate delivery within acute care (i.e. time to surgery), including rehabilitation within acute care (i.e. number of rehabilitation hours). Although measures of functional improvement (i.e. Activities of Daily Living) or balance (i.e. Berg balance scale) were used to evaluate patients’ progress within post-acute care settings (i.e. home-based rehabilitation), there were few quality of care indicators used. In an effort to improve quality of care for patients and create a more efficient healthcare system, mechanisms for the measurement of quality of care should be in place in both acute and post-acute settings.

Impact of findings: The implementation of quality of care indicators enables stakeholders to target areas for improvement in service delivery across the continuum. As hip fracture patients have significant morbidity that must be addressed in the post-acute care period, the inability to appropriately measure quality of care delivery during this period is concerning. Future work should focus on development of performance measures within the post-acute period.

Publications, presentations and webinars

About the Project

Hip fracture quality of care indicators were defined as a performance measure with a descriptive statement used in either the acute or post-acute care period. Literature search strategies were developed using medical subject headings and text words related to hip fracture quality indicators and were peer-reviewed.

This literature review on quality of care indicators for hip fracture patients revealed that although there are a number of previously used quality indicators for hip fracture patients residing in acute care, there are few quality indicators implemented within the acute care period. This finding is concering as hip fracture patients, due to the need for rehabilitation after surgery, require relatively more post-acute compared to acute care services.

The implementation of quality of care indicators enables stakeholders to target areas for improvement in service delivery across the continuum. As hip fracture patients have significant morbidity that must be addressed in the post-acute care period, the inability to appropriately measure quality of care delivery during this period is concerning. Future work should focus on devlopment of performance measures within the post-acute period.

For more details on the project rationale, objectives and research plan, click here.

Project Team

Principal Investigator:

Susan JaglalPhD, MSc, BSc -- University of Toronto

Co-Investigators:

Lauren Beaupre, PhD -- University of Alberta

Suzanne Morin, MD, MSc, FRCP, FACP -- McGill University 

Sarah Munce, PhD -- Toronto Rehabilitation Institute

Laure Perrier, MLIS, MEd -- University of Toronto

Knowledge Users and Partners:

Rhona McGlasson, MBA -- Bone and Joint Canada

Project Contact: Dr. Susan Jaglal -- susan.jaglal@utoronto.ca

KS 2013-07