The Early Activation Hip Fracture Care Bundle

Hip fractures are one of the top three causes of emergency admissions involving surgery in NSW. This patient group has a high hospital-acquired complication rate, resulting in patient suffering and unnecessarily high (and reducible) healthcare costs.

While the Australian Commission on Safety and Quality in Health Care National Hip Fracture Clinical Care Standard consolidates the best available evidence to manage this patient group, implementation of these guidelines is inconsistent and hospital dependent.

There is no validated model known to effectively implement the National Hip Fracture Standards to provide best-practice care to the 17,000 hip fracture patients treated in Australia each year.

Our eHIP research provides evidence from a real-world application to sustainably embed all components of the Standard into every day clinical practice.

eHIP provides a clear clinical process for the management of hip fractures, ensuring early activation of care and striving to improve patient outcomes.

The development of eHIP was a collaborative endeavour, involving key stakeholder groups – clinicians, managers, the NSW Agency for Clinical Innovation (ACI) and consumers – as well as the Local Health District Executive. 

Our study aims to improve patient outcomes and delivery of health services through research that is founded on translational research principles to maximise generalisability and scaling of the implementation of eHIP to other local health districts across NSW. To ensure sustained uptake the project includes an implementation tool-kit, informed by clinician behaviour change principles.

The implementation of eHIP positively impacts health service delivery by activating consistent integrated care from the time of presentation to the time of hospital discharge.

eHIP impacts individual patient care in two ways: by improving care, through pain assessment and management; and, by increasing patient and carer engagement through patient education and collaboratively developed, individualised care plans.

The implementation of eHIP is expected to:

• Reduce the incidence of hospital-acquired complications.
• Reduce the time from diagnosis to operative intervention.
• Increase the application of all seven components of the Hip Fracture Clinical Care Standard.
• Reduce overall treatment costs.