Current Care and Barriers to Optimal Care of People With Hip Fracture: A Survey of Hospitals in New South Wales, Australia

Background Fragility hip fractures are a common and often devastating event, and a shared care approach between orthopaedics and geriatrics can improve patient, health service and quality of care outcomes. The aim of this cross-sectional survey, administered to all hospitals caring for patients with...

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Main Authors: Danielle Ní Chróinín MD, Zsolt J. Balogh PhD, Jennifer Smith BHSc, Glen Pang MHM, Jessica Wragg MHM, Magnolia Cardona PhD
Format: Article
Language:English
Published: SAGE Publishing 2025-03-01
Series:Geriatric Orthopaedic Surgery & Rehabilitation
Online Access:https://doi.org/10.1177/21514593251327551
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author Danielle Ní Chróinín MD
Zsolt J. Balogh PhD
Jennifer Smith BHSc
Glen Pang MHM
Jessica Wragg MHM
Magnolia Cardona PhD
author_facet Danielle Ní Chróinín MD
Zsolt J. Balogh PhD
Jennifer Smith BHSc
Glen Pang MHM
Jessica Wragg MHM
Magnolia Cardona PhD
author_sort Danielle Ní Chróinín MD
collection DOAJ
description Background Fragility hip fractures are a common and often devastating event, and a shared care approach between orthopaedics and geriatrics can improve patient, health service and quality of care outcomes. The aim of this cross-sectional survey, administered to all hospitals caring for patients with acute hip fracture, in New South Wales (NSW), Australia, was to establish current models of care (e.g. shared care or other), and barriers and facilitators of best care. Methods A combination of quantitative and free-text data was collected. In total, 30/36 (83%) hospitals responded, with representation from all 15 state local health districts. Results Overall, 21/30 had a formal orthopedic surgery/geriatric medicine shared care model; orthopaedic surgery admission with routine (ortho)geriatrician input was commonest (13/21). Multiple barriers to optimal hip fracture care were identified along the various stages of the national guideline-recommended care pathway. Common barriers reported included staffing deficits (for pain assessment, fascia iliaca block administration) and gaps in service structure (lack of specialist services for refracture prevention). Multidisciplinary meetings were in place to enable best care and to promote team communication, but were impeded by absence of relevant team members (8/16). Free-text themes of enablers of good practice included clear escalation and hand-over processes, multidisciplinary communication strategies, and guideline-aligned clinical pathways. Conclusion Moving forward, addressing common barriers such as staffing and knowledge deficits, and harnessing enablers of good practice such as multidisciplinary communication and support, combined with effective implementation strategies, are likely to optimize care for patients with hip fracture.
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spelling doaj-art-8a857e9bbb1c4a2c8d16e024e7a35dec2025-08-20T02:51:45ZengSAGE PublishingGeriatric Orthopaedic Surgery & Rehabilitation2151-45932025-03-011610.1177/21514593251327551Current Care and Barriers to Optimal Care of People With Hip Fracture: A Survey of Hospitals in New South Wales, AustraliaDanielle Ní Chróinín MDZsolt J. Balogh PhDJennifer Smith BHScGlen Pang MHMJessica Wragg MHMMagnolia Cardona PhDBackground Fragility hip fractures are a common and often devastating event, and a shared care approach between orthopaedics and geriatrics can improve patient, health service and quality of care outcomes. The aim of this cross-sectional survey, administered to all hospitals caring for patients with acute hip fracture, in New South Wales (NSW), Australia, was to establish current models of care (e.g. shared care or other), and barriers and facilitators of best care. Methods A combination of quantitative and free-text data was collected. In total, 30/36 (83%) hospitals responded, with representation from all 15 state local health districts. Results Overall, 21/30 had a formal orthopedic surgery/geriatric medicine shared care model; orthopaedic surgery admission with routine (ortho)geriatrician input was commonest (13/21). Multiple barriers to optimal hip fracture care were identified along the various stages of the national guideline-recommended care pathway. Common barriers reported included staffing deficits (for pain assessment, fascia iliaca block administration) and gaps in service structure (lack of specialist services for refracture prevention). Multidisciplinary meetings were in place to enable best care and to promote team communication, but were impeded by absence of relevant team members (8/16). Free-text themes of enablers of good practice included clear escalation and hand-over processes, multidisciplinary communication strategies, and guideline-aligned clinical pathways. Conclusion Moving forward, addressing common barriers such as staffing and knowledge deficits, and harnessing enablers of good practice such as multidisciplinary communication and support, combined with effective implementation strategies, are likely to optimize care for patients with hip fracture.https://doi.org/10.1177/21514593251327551
spellingShingle Danielle Ní Chróinín MD
Zsolt J. Balogh PhD
Jennifer Smith BHSc
Glen Pang MHM
Jessica Wragg MHM
Magnolia Cardona PhD
Current Care and Barriers to Optimal Care of People With Hip Fracture: A Survey of Hospitals in New South Wales, Australia
Geriatric Orthopaedic Surgery & Rehabilitation
title Current Care and Barriers to Optimal Care of People With Hip Fracture: A Survey of Hospitals in New South Wales, Australia
title_full Current Care and Barriers to Optimal Care of People With Hip Fracture: A Survey of Hospitals in New South Wales, Australia
title_fullStr Current Care and Barriers to Optimal Care of People With Hip Fracture: A Survey of Hospitals in New South Wales, Australia
title_full_unstemmed Current Care and Barriers to Optimal Care of People With Hip Fracture: A Survey of Hospitals in New South Wales, Australia
title_short Current Care and Barriers to Optimal Care of People With Hip Fracture: A Survey of Hospitals in New South Wales, Australia
title_sort current care and barriers to optimal care of people with hip fracture a survey of hospitals in new south wales australia
url https://doi.org/10.1177/21514593251327551
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