Hip Fracture/TJR QBP Best Practice Frameworks

Supporting standardized rehabilitative care best practices

The RCA has created best practices frameworks for rehabilitative care for patients following hip fracture and primary hip and knee replacement. The frameworks establish guidelines for care and support implementation of quality-based procedures. 

The RCA has developed tools and resources to support implementation of the best practices at the system and organization level. This includes quick reference guides and self-assessment tools to help health services providers determine how well their current practice aligns with best practices.

A more detailed list of all activities for all RCA initiatives is found here.


In 2018, the Rehabilitative Care Alliance undertook a provincial self-assessment process which allowed health service providers to determine how well their current care aligns with best practices set out in the RCA's rehabilitative care best practice frameworks for hip fracture and primary hip and knee replacements. The RCA received 247 self-assessments (116 hip fracture/131 TJR) from 104 organizations across all 14 LHINs.

The results of the self-assessment provincial analysis were presented at the October 25, 2018 RCA Provincial Webinar found here.

Best practice implementation strategies from the high performing programs in each sector were shared to promote knowledge exchange. A summary of these strategies can be found here

Frameworks
Total Joint Replacement Framework (March 2017 / Rev January 2018) Includes the framework, referral decision tree, and process indicators to support performance monitoring of QBP-related outcomes.
Hip Fracture Framework (March 2017 / Rev September 2018) Includes the framework, referral decision tree, and process indicators for support performance monitoring and QBP-related outcomes.  
Quick Reference Guides
Total Joint Replacement (January 2018)
Based on the full framework. Provides a concise summary of best practices to guide clinical practice in each setting.
Hip Fracture (January 2018) Based on the full framework. Provides a concise summary of best practices to guide clinical practice in each setting. 
Self-Assessment Tools
Total Joint Replacement Self-Assessment (January 2018)
Simple tools to help health service providers assess how well their current care aligns with best practices. Also provides immediate feedback to help improve care. 
Hip Fracture Self-Assessment (January 2018)
Simple tools to help health service providers assess how well their current care aligns with best practices. Also provides immediate feedback to help improve care. 
Implementation Toolkit
Toolkit for Implementing Best Practice Frameworks (January 2018) Slide deck with overview of QBP Best Practice Frameworks, Quick Reference Guides and self-assessment process. 
FAQ - Hip Fracture/TJR QBP Best Practice Frameworks (January 2018) Answers to frequently asked questions about the frameworks and self-assessment process. 
QBP Clinical Handbooks
Quality-Based Procedures: Clinical Handbook for Primary Hip and Knee Replacement (November 2013) Published by Health Quality Ontario and MOHLTC
Quality-Based Procedures: Clinical Handbook for Hip Fracture (May 2013) Published by Health Quality Ontario and MOHLTC