Australian and New Zealand Hip Fracture Registry 2021 Annual Report

The Australian and New Zealand Hip Fracture Registry (ANZHFR) has released its sixth patient level report and ninth facility level report with a continued focus on performance against the binational Hip Fracture Care Clinical Care Standard. The ANZHFR has seen a year-on-year increase in Registry participation, with 86 hospitals (64 Australian hospitals and 22 New Zealand hospitals) contributing data on 14,816 patient care episodes and 117 hospitals providing facility level data to the 2021 report.

Progress is evident in a number of domains of hospital care including assessment of cognition, assessment and management of pain, identification of delirium in the post-operative phase and provision of written information for patients as they transition from the acute hospital setting. Pleasingly, geriatricians continue to be increasingly involved in the management of older people who have fractured their hip, represented by the growing number of ANZ hospitals reporting shared care arrangements (31% of ANZ hospitals) or regular input by an orthogeriatric liaison service (29% of ANZ hospitals), the two most common models of care reported. Fewer hospitals reported that no formal arrangements exist.

For the first time, actual first day mobilisation is reported, which shows that whilst 90% of patients were given the opportunity to mobilise on the day after surgery, only 47% achieved stepping or walking.  Considerable variation was evident between hospitals and their performance on this aspect of care, with some hospitals getting over 90% of patients out of bed the day after surgery, whilst at other hospitals it is as low as 20-30%. Further work is needed to understand and address barriers to first day mobilisation.

The number of people leaving hospital on treatment for osteoporosis remains low (27%), without much improvement over time. Understanding why there has been little progress is a priority for ANZHFR, and further work is planned in the form of a Sprint Audit, which will look in greater detail at prescription and administration of bone protection medication before patients leave hospital.

The report also includes a new outlier report, which monitors hospital performance against the Hip Fracture Care Clinical Care Standard quality indicators and enables sites to easily see areas of high quality care or those that require review.

Electronic copies of both the printed version of the Annual Report, and a full digital report, which covers additional domains not included in the printed report are available at www.anzhfr.org. To listen to ANZHFR Co-chairs Professors Jacqueline Close and Ian Harris discuss the highlights of the report and key areas of focus for the future, tune into the ANZHFR podcast series Hipcast.

In other ANZHFR news, top performing hospitals in Australia and New Zealand were recently recognised for their achievements against the Hip Fracture Care Clinical Care Standard quality indicators, with the Inaugural Golden Hip award. The Golden Hip award was initiated by the Scottish Hip Fracture Audit to promote and reward better health care for people with hip fractures. The ANZHFR congratulates the finalists and the winning hospitals – Princess Alexandra Hospital in QLD, Australia (pictured) and North Shore Hospital, on New Zealand’s North Island, who took out the prize for the best overall performance against the Clinical Care Standard.

You can keep up to date on ANZHFR events and all things hip fracture related by following ANZHFR on Twitter and LinkedIn. For information on participating in the ANZHFR, contact Jamie Hallen j.hallen@neura.edu.au.