Hip fracture quality indicators: a scoping review (Final Results of CFN Knowledge Synthesis Grant)

Over 30,000 hip fractures (hip#) occur annually in Canada. They are the second leading cause of hospitalization for Canadian seniors and are expected to increase by 2031, when approximately 25% of Canadians will be 65 years or older. Dr. Susan Jaglal of the Toronto Rehabilitation Institute, and PhD candidate Kristen Pitzul shared the results of their synthesis of the evidence surrounding current quality-of-care indicators for patients who have sustained a hip fracture.

Loss of function and autonomy, as well as excess mortality, is common following hip#, and subsequently care for these patients must be optimized. Prior to optimizing quality of care for these patients, however, there must be a mechanism for the measurement of quality of care delivery across all care settings. No such mechanism currently exists in Canada for hip fracture patients. Synthesis results suggest there are currently few indicators of quality of care delivery in the post-acute setting, however there are some outcomes measures that could potentially be used as quality indicators in the future. Due to the required rehabilitation for hip fracture patients after discharge from acute care, the lack of indicators in the post-acute period is concerning. This synthesis will enable decision makers to identify areas of care delivery that require improvement, ultimately making positive changes in the care of frail elderly Canadians.

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Dr. Susan Jaglal is a Professor and Vice-Chair, Research, in the Department of Physical Therapy at the University of Toronto, with cross-appointments in the Department of Health Policy, Management and Evaluation and the Dalla Lana School of Public Health. She holds the Toronto Rehabilitation Institute Chair at the University of Toronto, and is a Senior Scientist at the Institute. She has a PhD in Epidemiology from the University of Toronto, and is currently the President of the Canadian Society for Epidemiology and Biostatistics. Dr. Jaglal has published and lectured widely in her areas of research, which include osteoporosis and rehabilitation health services with emphasis on utilization, appropriateness, effectiveness of services and knowledge transfer.

Kristen B. Pitzul is a PhD candidate in Health Services Research at the Institute of Health Policy, Management, and Evaluation at the University of Toronto. Kristen holds a Masters of Science in Physiology and Bachelor of Science in Honours Biology from the University of Western Ontario. As an aspiring methodologist, Kristen’s research interest include performance measurement, program evaluation, and knowledge synthesis. Kristen’s doctoral thesis, supervised by Dr. Susan Jaglal, is focused on the optimization of post-acute care pathways in hip fracture patients.