Australian and New Zealand Hip Fracture Registry 2022 Annual Report
The Australian and New Zealand Hip Fracture Registry (ANZHFR) has recently released its seventh patient level report, detailing hospital performance against key markers of high-quality hip fracture care. In this report, 93 hospitals (71 Australian hospitals and 22 New Zealand hospitals) contributed data on 15,331 patient care episodes.
There has been ongoing progress in clinical indicators such as assessment of cognition prior to surgery and assessment of delirium (year-on-year improvements in both countries in both domains); the use of nerve blocks to manage pain; and the increase in the proportion of hospitals that have a weekend therapy service.
In New Zealand, 85% of hip fracture patients saw a geriatrician during their acute hospital stay, representing an increase over time. In Australia, 88% of patients were seen by a geriatrician, which is unchanged from 2020 but represents a decrease over the last five years. The tenth facility level audit, which included 117 ANZ hospitals and is also reported on, explored the impact of COVID-19. In some hospitals, staff deployments and changes to the way hip fracture patients were cared for throughout the pandemic reduced the availability of orthogeriatric services.
The report also highlights a number of areas that require improvement:
- Average time to surgery remains unchanged. Difficulty accessing theatre is reported as the reason for delay in nearly 30% of cases where surgery occurred beyond 48 hours. This remains a system level problem requiring collaboration between clinicians and executives within our facilities.
- First day walking occurred in 49% of patients on average, with huge variation in both countries.
- There has been some progress in the proportion of people on bone protection medication at discharge, with an increase from 24% in 2017 to 29% in 2021 in Australia. However, the data continues to highlight substantial variation between hospitals and represents a significant missed opportunity to contribute towards preventing another fracture
The printed report again focuses on performance against the Hip Fracture Care Clinical Care Standard (HFCCCS). A full e-report covers additional domains not included in the printed report. The Australian State report is included in both the printed and the e-reports. The full e-report and an electronic copy of this report can be read here.
In other news, the ANZHFR is also looking forward to the upcoming binational Hip Festival in Melbourne on Wednesday 19th October, 2022. The event is being held in partnership with the Fragility Fracture Network Global Congress (20-22 October). The Hip Fest will offer a forum to explore multidisciplinary teamwork in hip fracture care and highlight examples of best practice.
The 2022 Australian Golden Hip Awards will also be presented on the day, recognising top performing and most improved hospitals in Australia against the quality indicators in the HFCCCS. The New Zealand Golden Hip Awards have recently been announced, with North Shore Hospital winning best overall performance and Hutt Hospital winning most improved. The ANZHFR congratulates all the finalists for their achievements providing high-quality care.
