Rehab in Acute Care

Rehab in Acute Care — Hip Fracture

Acute Care
Best Practices for Hip Fracture

Rehabilitative Care for Older Adults Living With/At Risk of Frailty: From Frailty to Resilience (May 2024)

Hip Fracture: Addendum to Rehabilitative Care for Older Adults Living With/At Risk of Frailty: From Frailty to Resilience (Updated August 2024)

 Both documents should be consulted when providing best practice care to older adults with hip fracture. Together, they provide rehabilitative care best practices for all older adults with frailty, including those with hip fracture, and additional recommendations specific to hip fracture.

Please note: These two documents replace the earlier Hip Fracture Framework (March 2017/Rev Sept 2018).

 
Rehabilitative Care Best Practices for Hip Fracture in the Context of COVID-19 (October 2020)  Additional evidence-based recommendations that align with current COVID-19 restrictions.
Patient & Family Education Materials
Hip Fractures – Canadian Orthopaedic Foundation Website helps patients and caregivers learn how to prepare for and recover from a hip fracture, including patient and caregiver booklet, assistive devices, home adaptation, getting active nutrition and osteoporosis.
Canadian Osteoporosis Patient Network A national network of people living with osteoporosis.
Centre for Hip Health & Mobility FReSH START Toolkit

Available in 6 languages

 Hip fracture recovery guide for patients and families, reviews what to expect in hospital, at home, mobility and exercises. Video links embedded.
Holland Bone & Joint Program Hip Fracture Patient Education Patient education web pages provide an overview of hip fracture and walks the patient through what to expect in the emergency room, OR and post-operatively.
Ontario Health Quality Going Home From the Hospital Booklet reviews questions for patients and caregivers to ask the care team as they get ready to leave the hospital.
Ontario Health Quality Hip Fracture Patient Reference Guide Booklet reviews what patients and caregivers should ask for in their care.
Ontario Osteoporosis Strategy — Your Fracture Journey Online tool reviews causes of fractures, risk reduction, management options and managing pain.
RGPO Caregiving Strategies Handbook Handbook for the family and friend caregivers who support seniors experiencing frailty. Created with advice from caregivers across Ontario, this handbook had been reviewed by health care professionals.
Too Fit to Fracture – One Page Resource One page resource that provides guidance on managing osteoporosis through exercise
Assessment & Intervention
Hip Fracture – The Rest Isn’t Orthopaedics

 This podcast and educational resource series explores the multidisciplinary care of older adults with hip fractures, emphasizing that while orthopaedic surgery is vital, recovery depends on the collaboration of the entire healthcare team.
Alberta Health Services Hip Fracture Care Pathway Toolkit Provincial clinical pathways developed to guide the care of patients who have had a hip fracture.  The toolkit includes order sets, patient education materials and assessment tools.
BC Guidelines — Frailty Identification Guideline addresses the early identification and management of older adults with frailty or vulnerable to frailty.
Bone & Joint Canada National Hip Fracture Toolkit Toolkit provides a systems view of care that addresses the barriers patients experience as they transfer through the health care system.
Bone Fit™ Provides professional training on the most appropriate, safe and effective methods to prescribe and progress exercise for people with osteoporosis.
Capture the Fracture® Global program that provides recognition, resources, training and tools to support Post-Fracture Care Coordination Programs.
Fragility Fracture Network – Clinical Practice Guidelines for PT Management of Older Adults with Fracture Webinars provide information on the implementation of a clinical practice guideline for physical therapy management of older adults with fracture.
Clinical Frailty Scale (CFS) 2.0

Clinical Frailty Scale – Geriatric Medicine Research (Dalhousie University)

 Clinical Frailty Scale (CFS) designed to summarize the results of a Comprehensive Geriatric Assessment and now commonly used as a triage tool to make important clinical decisions.
A Competency Framework for Interprofessional Comprehensive Geriatric Assessment

CGA Self-Assessment Tool (Inter-professional) – Provincial Geriatrics Leadership Ontario

 Comprehensive Geriatric Assessment (CGA) guides a multidimensional specialized geriatric team approach to care that determines a frail older person’s biomedical, psychosocial, functional, and environmental needs, and initiates an appropriate treatment and follow-up plan. Competency framework describes detailed practice expectations of health professionals participating in the CGA.
Fragility Fracture Network Clinical Toolkit Toolkit supports delivery of best practice care for persons who suffer hip, clinical vertebral or other major fragility fracture in acute care, rehabilitation and secondary prevention.
JOSPT Physical Therapy Management of Older Adults with Hip Fracture Clinical Practice Guidelines linked to the International Classification of Functioning, Disability and Health from the Academy of Orthopaedic Physical Therapy and the Academy of Geriatric Physical Therapy of the American Physical Therapy Association.
North East Specialized Geriatric Centre — Baseline Functional Status Addresses baseline functional status, how baseline functional status is determined and subsequent determination of restorative potential.
Ontario Health Hip Fracture Care Implementation Toolkit Contains practical strategies and useful resources to support hospitals to implement the Hip Fracture Quality Standard.
Ontario Health Quality Hip Fracture Quality Standard Quality standard based on evidence and expert consensus. Includes patient reference guide, recommendations for adoption, getting started guide and indicator guide.
Ontario Osteoporosis Strategy Health care provider website related to osteoporosis and fracture prevention.
Orthogeriatrics: The Management of Older Patients with Fragility Fractures  Orthogeriatrics open access textbook.
Clinical Practice Guidelines 2023 – Ontario Osteoporosis Strategy Reference sheet for health professionals on the 2010 clinical practice guidelines for the diagnosis and management of osteoporosis.
Cognitive Screening Toolkit – Provincial Geriatrics Leadership Ontario Toolkit to help clinicians better understand cognitive screening tools and select the appropriate tool.
Provincial Geriatrics Leadership Ontario Family Presence in Older Adult Care Statement to support the restoration of family presence and aid the fulfilment of commitments to patient and family-centred care.
Transition Planning
Ontario Health Quality Transitions between Hospital and Home Quality Standard Quality standard based on evidence and expert consensus. Includes patient guide, getting started guide, case for improvement, data table and measurement guide.
GTA Rehab Network Inter-Organizational Transfer of Accountability (TOA) Guidelines Guidelines provides six principles that support the interactive process of transferring information and coordinating follow-up care between organizations across the patient lifespan and care continuum.
GTA Rehab Network Discharge Checklist Checklist outlines key information that should be provided at the time of transfer to the next level of care (to hospital or community) in order to support patient safety and continuity of care.
Holland Bone & Joint Program Hip Fracture Project (FHRAT) Website describing the Fractured Hip Rapid Assessment and Treatment Service (FHRAT) at Sunnybrook Health Sciences Centre.