Reports, Presentations & Publications


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    The ANZHFR have produced a series lectures in 2020 in lieu of the state based Hip Fests. The lectures can be accessed by clinicians at anytime and are designed to share good practice and solutions to common problems. We plan to return to face to face meetings in 2021.

    To learn more about the latest updates in hip fracture care, please subscribe to the ANZHFR Education and Training YouTube Channel.

     

     

    Lecture 1- Team work makes the dream work

    Improving time to surgery for hip fracture patients. Dr Saqib Zafar, Orthopaedic surgeon tells us how this was achieved with a dedicated hip fracture team at Nepean Hospital in New South Wales, Australia.

    Click here to view the lecture (19:00 mins)

    For more information, refer to the Hip Fracture Care Clinical Care Standard, Quality Statement 4, Timing to Surgery.

     

    “Dream Team” at Nepean Hospital, NSW, Australia

    Back Row: Jenny Smith – Orthopaedic CNC, Ashley O’Rourke Nurse Manager Aged Care & Rehabilitation, Aaron Hall Fracture Liaison Coordinator, Emma Saad Program Lead for Patient Reported Measures, Dr John Farey Orthopaedic Registrar

    Front Row:  Dr Anita Sharma Head of Medical Division & Department Head Geriatric Department, Dr Eli Olschewski Orthopaedic Surgeon, Jacquie Hampton Program Lead for Leading Better Value Care

     

     

    Lecture 2- High intensity physiotherapy for hip fractures

    Dr Lara Kimmel, team leader and physiotherapist describes how High Intensity Physiotherapy for Hip Fractures is provided at The Alfred Hospital, Victoria, Australia. Dr Kimmel presents the results of the HIP4Hips randomised control trial and explains how they are able to provide this model of physiotherapy as “business as usual” at The Alfred.

    Click here to view the lecture (14:50 mins)

    For more information, please refer to the Hip Fracture Care Clinical Care Standard, Quality Statement 5- Mobilisation and Weight Bearing.

     

    Lecture 3- Total hip replacement versus hemiarthroplasty in the management of hip fractures

    Consultant orthopaedic surgeons, Dr Marinis Pirpiris and Prof Ian Harris discuss the use of total hip replacements versus hip hemiarthroplasty in the management of hip fractures. They will also be discussing the use of dual mobility hip replacements.

    Click here to view the lecture (9:00 mins)

    For more information, please refer to the Hip Fracture Care Clinical Care Standard, Quality Statement 4- Timing of Surgery and Quality Statement 5- Mobilisation and Weight Bearing.

     

    Lecture 4 – Direct oral anticoagulants and emergency surgery

    Dr Agnes Yuen is a Haematologist from Melbourne Haematology and research fellow at Monash Health, Victoria, Australia. She will be discussing direct oral anticoagulants and emergency hip fracture surgery.

    Click here to view the lecture (8:30 mins)

    For more information, please refer to the Hip Fracture Care Clinical Care Standard, Quality Statement 4- Timing of Surgery.

     

    Lecture 5- eHIP- A hip fracture journey

    Mr Peter Moules, Registered Nurse in ED describes how care was improved with an innovative eHIP bundle of care and prompt notification system involving the MDT Hip Fracture team at Wollongong Hospital, New South Wales, Australia.

    Click here to view the lecture (10:30 mins)

    Click here to view the eHIP – Illawarra Shoalhaven Local Health District Hip Fracture Pathway (02:47 mins)

    For more information, please refer to the Hip Fracture Care Clinical Care Standard, Quality Statement 1- Care at Presentation.

     

    Lecture 6- Role of transthoracic echo in hip fracture

    Dr Matthew Beech, Staff Specialist Anaesthetist at Gold Coast University Hospital, QLD Australia and Prof Jacqui Close, co-chair of ANZHFR discuss the role of transthoracic echo in hip fracture.

    Click here to view the lecture (7:05 mins)

    For more information, refer to the Hip Fracture Care Clinical Care Standard, Quality Statement 4, Timing to Surgery.

     

    Lecture 7 – An introduction to the fragility fracture network

    Mr Paul Mitchell is an Adjunct Senior Lecturer at University of Notre Dame, Australia and Chair of the Communications Committee, Fragility Fracture Network. He provides an introduction to the Fragility Fracture Network- a global call to action.

    Click here to view the lecture (10:20 mins)

    For more information, refer to the Hip Fracture Care Clinical Care Standard, Quality Statement 6, Minimising the Risk of another Fracture.

    For more information about the Fragility Fracture Network, please visit their website: www.fragilityfracturenetwork.org

     

    Lecture 8- When not to operate and when to palliate. A shared care approach.

    Dr Hannah Seymour, Geriatrician at Fiona Stanley Hospital, Western Australia and Prof Jacqui Close, co-chair of ANZHFR discuss when not to operate on hip fracture patients towards the end of their lives.

    Click here to view the lecture (11:00 mins)

    For more information, please refer to the Hip Fracture Care Clinical Care Standard, Quality Statement 3- Orthogeriatric Model of Care.

     

    Lecture 9- Ethics and Governance

    Learn about the finer points of ethics and governance with Ms Elizabeth Armstrong, Manager of the Australian Hip Fracture Registry.

    Click here to view the lecture (3:00 mins)

     

    Lecture 10- Data Quality

    Ms Elizabeth Armstrong, Manager of the Australian Hip Fracture Registry explains the three C’s of data quality- completeness, correctness and capture.

    Click here to view the lecture (4:40 mins)

     

    Lecture 11- Bone Protection Medication Upon Discharge

    Join Prof Jacqui Close, co-chair of ANZHFR for a Q & A with Dr Bianca Wong, Geriatrician from the Lyell McEwin Hospital, South Australia. Dr Bianca Wong discusses how they are able to achieve a high rate of initiating osteoporosis medication at her hospital.

    Click here to view the lecture (8:00 mins)

    For more information, please refer to the Hip Fracture Care Clinical Care Standard, Quality Statement 3- Orthogeriatric Model of Care.

     

    Lecture 12- Malnutrition and Hip Fracture

    Join Prof Ian Harris, co-chair of ANZHFR for a Q & A with Dr Jack Bell, Dietitian from The Prince Charles Hospital, Queensland and ANZHFR Steering Committee member. Dr Jack Bell discusses the importance of malnutrition and SIMPLE nutrition care for hip fractures.

    Click here to view the lecture (8:33 mins)

    For more information, please refer to the Hip Fracture Care Clinical Care.

     

    Lecture 13- Bone Health After Hip Fracture

    Dr P.K Shibu Nair is a Geriatrician from the Queen Elizabeth Hospital, South Australia. Queen Elizabeth Hospital are able to achieve a high rate of initiating osteoporosis medication prior to discharge. Dr P.K Shibu Nair explains the importance of bone health after hip fracture.

    Click here to view the lecture (7:15 mins)

    For more information, please refer to the Hip Fracture Care Clinical Care Standard, Quality Statement 6- Minimising the risk of another fracture.

     

    Lecture 14- HIPFIT and Beyond

    Professor Maria Fiatarone Singh is a Geriatrician at The University of Sydney, New South Wales. She describes her research in rehabilitation after hip fracture and the effects of high intensity progressive resistance training as well as targeted multi-disciplinary treatment. She gives context to the randomised control study and describes how this research can be translated into a wider scope.

    Click here to view the lecture (16:00 mins)

    For more information, please refer to the Hip Fracture Care Clinical Care Standard, Quality Statement 7- Transition from Hospital Care.

    Read the abstract of the article here.

     

    Lecture 15- Hip fracture care in the remote setting – Northern Territory, Australia

    Stephanie Thornton, Nurse Management Consultant, Central Australia Health Service, discusses the unique physical and cultural challenges of hip fracture care in a remote setting. Hear Stephanie discuss issues of transporting patients long distances, engaging with patients in a culturally appropriate manner and the necessity to think outside the box with regard to equipment provision!

    Click here to view the lecture (10.00 mins)

    For more information, please refer to the Hip Fracture Clinical Care Standard –  Quality Statement 7- Transition from Hospital Care.

     

    Lecture 16- Analgesia for fractured neck of femur

    Anaesthetists, Dr John Barry and Dr Sean McManus discuss the role of the anaesthetist in the care of the patient with fractured neck of femur, including the challenges of pain management in the older patient, particularly those with cognitive impairment. Elderly patients with hip fracture are at risk of being undertreated for pain which can contribute to longer lengths of stay and poorer functional outcomes. John and Sean discuss the advantages and disadvantages of different modes of analgesia that are available and the clinical significance of fascia and femoral nerve blocks.

    Click here to view the lecture (9.00mins)

    For more information, please refer to the Hip Fracture Clinical Care Standard, Quality Statement 2 – Pain Management

     

  • Welcome to the 2020 Annual Report which includes the fifth patient level report and the eighth facility level report.

    This year, 77 hospitals have contributed patient level data and 117 hospitals have provided facility level data to the report.

    We are enormously grateful to all of the teams working in our hospitals across Australia and New Zealand who give of their time to enter data to the Registry.

        

    2020 Annual Report                   2020 Supplementary Report

  • Welcome to the 2019 Annual Report. The 2019 Annual Report contains patient level data from 67 hospitals and facility level data from 118 hospitals across Australia and New Zealand. It is the fourth year of reporting patient level information and the seventh year of reporting facility level elements of care provided by hospitals to patients with a fractured hip.

    There has been steady progress in hospital participation from 24 hospitals reported in the first patient level report. The commitment to improving hip fracture care from clinical, administrative or executive staff is evident by this continued growth of the Registry. We recognise the time commitment and challenges of collecting data at each contributing site. Thank you to all those who have provided data for the facility level and/or patient level reports.

    The 2019 Annual Report shows significant national improvement in hospital pain management and early rehabilitation for people being treated for a broken hip. It shows 87% of patients in Australia receive a nerve block injection to help manage pain after a hip fracture, up from 59% when annual reporting began in 2015. Hospitals have also improved early rehabilitation activities, with 91% of patients now being offered treatment to get out of bed and start walking the day after surgery.  This is an increase from 85% in 2015.

    This year, the ANZHFR has also released the My Hip Fracture Guide. This guide for patients, families and carers contains important information about recovering after a hip fracture. It also contains an individualised care plan which can be used to assist the patient’s transition from hospital care. The My Hip Fracture Care Guide is formatted to print as an A5 booklet.

    Click on the report and My Hip Fracture Guide below to download your copy.

     2019 Erratum ANZHFR Annual Report   

    2019 Annual Report            2019 Erratum ANZHFR Annual Report     2019 Supplementary Report       My Hip Fracture Care Guide

     

  • The second NZ Hip Festival in the South Island was held on 18th September 2019 in Christchurch. This was another great attendance with 30 people participating from 12 hospitals and 10 DHB’s. Presentations ranged from acute care about nerve blocks and orthopaedic procedures to post op care regarding osteoporosis. There were also additional presentations about a falls project and the national Live Stronger for Longer campaign, with the day ending with a focus on data improvement and project work.  The presentations on nerve blocks and orthopaedic procedures stimulated much discussion.

    The feedback collected from the South Island Hip Fest attendees highlighted most had found it a valuable experience. In particular, attendees had an opportunity to network with other DHB personnel and to understand how their processes compared with their own hospital. Also, they enjoyed the content as it related directly to their day to day work.

    South Island Hip Fest attendees

    South Island Hip Festival Presentations:

    ANZHFR Background_Roger Harris

    Live Stronger for Longer Presentation_Shankar_Sankaran

    Fascia Iliaca Block Service_Richard Seigne

    Orthopaedic Treatment of Hip Fractures_Mark Wright

    Osteoporosis, who to treat and when_John Elliot

    Improving falls prevention referrals post fracture_Dr John Geddes

    Data Quality_Roger Harris

    Using ANZHFR Data to Improve Care_Bill Wilson

     

  • The ANZHFR Hip Fests have travelled across the Tasman to the North Island of New Zealand. The ANZHFR NZ Hip Festival 2019 was held at Middlemore Hospital, Auckland on 17th July 2019. The theme of the festival “from Fracture to Fixed” guided the presentations for the day and included information from presenters in regards to data, standards and improvement in hip fracture care. North Island Hospitals were encouraged to bring along their hip fracture “dream team”. For those in the South Island NZ, please keep a lookout for the Hip Festival event travelling to Christchurch in September 2019.

    left to right: Dr Roger Harris, Mrs Nicola Ward and Dr Sarah Hurring

    North Island Hip Festival Presentations:

    10.00_ANZHFR Background_Roger Harris

    10.15_Live Stronger for Longer Movement_Dr Shankar Sankaran

    11.10_Emergency Department-Assessment and Management Presentation_Dr Owen Doran

    11.25_ Orthopaedic Treatment of Hip Fractures_ Mr Mark Wright

    11.40_ Secondary Fracture Prevention_Marilyn Scott

    12.15_Data Accuracy, Quality and Completeness_Roger Harris

    13.45_FIB Middlemore Hospital Journey_Hla San Tha

    14.00_The March of the Centenarians_Dr Min Yee Seow

  • The QLD Hip Fest was held at The Prince Charles Hospital on Friday 31st May, 2019. The event had a great turnout from Queensland Hospitals and Health Services, Northern NSW hospitals as well as private hospital representation. Over 185 people participated in the QLD Hip Fest by attending in person or via videoconference. We hope you were able to take away from the day the latest, best practice in hip fracture care as well using data to change your practice. Please find below copies of the presentations from the QLD Hip Fest.

    Back row left to right: Ms Naomi O’Rourke, Ms Monica McCarron, Dr Chrys Pulle, Ms Rebecca Ferrier, Dr Catherine McDougall, Dr Scott Crawford, Prof Jacqui Close and Dr Jack Bell. Front row left to right: Ms Kate Bell, Dr Alisa Crouch, Mr Stewart Fleming and Ms Elizabeth Armstrong

    Enthusiastic QLD Hip Fest attendees fill the Mark O’Brien Auditorium, The Prince Charles Hospital.

     

    QLD Hip Fest Presentations:

    09.15_ANZHFR Background QLD_JClose

    09.35_ANZHFR Qld Experience_CPulle

    09.50_Australian Hip Fracture Registry_SFleming

    11.15_Early Mobilisation_RFerrier

    11.30_Toowoomba Hospital_MMcCarron

    12.05_Aspects of Pain Management_JBarry

    11.45_Secondary Fracture Prevention_KBell

    12.20_Timing to OT_ NO’Rourke

    2.50_Treatment for Femoral Neck Fractures_SCrawford

    14.00_Change Methodology_JBell

  • The ANZHFR is continuing its series of state-based festivals to provide opportunities to share ideas on improving hip fracture care. In March 2019, events were held in both Adelaide and Launceston. Both events were well supported and it was interesting to hear from local teams the different challenges faced in different States across Australia. Keep a lookout for upcoming events near you in Queensland, New Zealand and Victoria. Find below copies of the presentations from both events in South Australia and Tasmania.

        

    Dr Bianca Wong                                     SA Hip Fest attendees                         Dr Faizal Ibrahim

     

    SA Hip Fest, Education Centre, Modbury Hospital, 5th March 2019

    Presentations:

    HipFest_SA_Session1__Background_05March2019

    HipFest_SA_Session1__SAExperience_05March2019

    HipFest_SA_Session2__FracturePrevention_05March2019

    HipFest_SA_Session2__ANZHFRDatabase_05March2019

    HipFest_SA_Session3__DeliriumRisk_05March2019

    HipFest_SA_Session 3__Rehabilitation_05_March2019

    HipFest_SA_Session3__PainManagement_05March2019

     

     

    TAS Hip Fest attendees, Launceston Clinical School

     

     

    TAS Hip Fest, Launceston Clinical School, 28th March 2019

    Presentations:

    HipFest_TAS_Session1__EDPathway_28March2019

    HipFest_TAS_Session1__ToOperateorNot_28March2019

    HipFest_TAS_Session1__OperativeTreatment_28March2019

    HipFest_TAS_Session1__Orthogeriatrics_28March2019

    HipFest_TAS_Session2__ANZHFR_28March2019

    HipFest_TAS_Session2__OptimalCareModel_28March2019

    HipFest_TAS_Session2__RegistryinTasmania_28March2019

    HipFest_TAS_Session2__ANZHFRDatabase_28March2019

     

  • The ANZHFR has commenced a series of state-based festivals to provide an opportunity to share ideas on improving hip fracture care. They will offer a forum to learn from each other, highlight examples of best practice, and identify and share issues and solutions that are common across hospitals to help drive improvement in hip fracture care. The first two events have been held in WA and NSW. Find below copies of the presentations from the NSW event.

    2_LBVC Hip Fracture Care

    3_FLS_ORP_ Julia_Rory

    4_Using_Data_to_improve_Hip_Fracture_Care

    5_Rehabilitation after Hip Fracture

    6_ANZHFR_Database_Stewart_Fleming

    7_RNSH_EMR_Project

    8_Fascia_Iliaca_Block

    9_Time to surgery

    10_Orthogeriatric Model of care

    Session 3 ACI Workshop

  • The first of the ANZHFR series of state-based Festivals kicked off with the WA Hip Fest, held at Fiona Stanley Hospital on 23rd October 2018. The Hip Festivals are an initiative of the Registry to harness the collective knowledge of key stakeholders and to inspire and enable those involved in the provision of hip fracture care.

    The program included presentations from the Royal Flying Doctor Service, variation in anaesthetics, a regional perspective of hip fracture care from Albany and considerations for surgical management and weight bearing status post hip fracture. Attendees had the opportunity to work collaboratively in the afternoon workshop sessions to brainstorm solutions to issues that are common across WA hospitals. The ANZHFR is looking forward to bringing this event to the other Australian states as well as New Zealand.

    Left to right: Fiona Stanley Hospital, WA Hip Fest attendees, Dr Luke Pritchard

    Left to Right: Dr Ed O’Loughlin, workshop participants and Dr Hannah Seymour, Paul Artis and Lisa Welthy

     

    WA Hip Fest Presentations:

    9.10am_WA Hip fracture Experience_ Dr Hannah Seymour

    9.30am_Time to OT_RFDS Presentation- Dr Luke Pritchard

    9.50am_Standardising Anaesthesia for NOFs_Dr Ed OLoughlin

    11.15am_Regional Perspective of Hip Fracture Care_Dr Airell Hodgkinson

    11.35am_ To Weightbear or not to Weightbear _Mr Andrew Mattin

    11.55am_ANZHFR Database_ Mr Stewart Fleming

  • Welcome to our third patient level and sixth facility level report. Over the past year, we have continued to see additional sites join and contribute data to the Registry.

    The facility level report contains information from all 116 public hospitals across Australia and New Zealand that operate on people with a hip fracture. We welcome the addition of two private hospitals that have joined us in 2017.

    The report also contains data from 56 hospitals contributing patient level data, a figure that has risen from 34 hospitals in the previous year and continues to increase. We now have over 20,000 data-sets in the Registry and opportunities exist to explore this data in more detail.

    For the first time, we are identifying hospitals. New Zealand has elected to publish the names of all hospitals entering patient-level data, whilst Australia is identifying hospitals where individual site level approval has been obtained.

    Pleasingly, 83% of Australian hospitals agreed to be identified in this report. Our hope is that more clinicians of all professions will see their own data and use the data to drive change at a local level. Equally, we want teams to share their successes and learnings with other Registry sites. What remains apparent is the marked variation in a number of the process measures, including indicators, which have a real impact for the patient: assessment and management of pain, time to surgery and secondary fracture prevention.

    Click the report below to download your copy.

    2018 Annual Report

    2018 Supplementary Report

    NeuRA has also produced a series of educational videos available for all seniors on our seminar platform NeuRatalks.org.

    Watch the NeuRA talks miniseries on HIP FRACTURE care

    Download NeuRA Brochure: Hip Fracture Care Guide

  • It is with great pleasure that we welcome you to the second Australian and New Zealand combined patient and facility-level report. This is the 5th year we have provided an annual report on activities within facilities across both countries but only the second year that we have included patient-level data.

    These reports build on the groundwork of the ANZHFR since its inception in 2012, including the production of the Australian and New Zealand Guideline for Hip Fracture Care. The release in 2016 of the Hip Fracture Care Clinical Care Standard and its associated quality indicators – a combined effort from the Australian Commission on Safety and Quality in Health Care and the Health Quality and Safety Commission New Zealand, has allowed us to align our reporting to those standards.

    This provides hospitals with clear information regarding their standard of care for each of the quality statements. The patient-level audit (the first part of this report shows data grouped by hospital so that hospitals can be compared. Each hospital is numbered (anonymised) for this report but each hospital is provided with their identification number. In future, and with the agreement of participating hospitals, we aim to include hospital names in this report to provide transparency and to give hospitals a greater incentive to improve their performance.

    Data are also grouped by country, and we have provided overall results for each country for 2016 and 2017 to show any changes that have occurred between the two reports. We hope that in future, this will map the improvements made to hip fracture care since inception of the Registry.

    For the first time, the report incorporates patient health outcomes beyond discharge. Information on rates of death and on walking ability are included under 30 day and 120-day outcomes, although not all sites are collecting this information.

    Click the report below to download your copy.

    Want to present this to your team? Here is a Powerpoint Presentation that shows off the 2017 Annual Report.

  • Here is the first annual report for the Australian & New Zealand Hip Fracture Registry.

    Hip fracture is the most serious and costly fall-related injury suffered by older people. There were an estimated 19,000 admissions to hospital for a hip fracture among Australians aged over 50 in 2011-12, an increase of 22% in absolute number since 2002-03. 1 In New Zealand, 3803 people were admitted to hospital with a hip fracture in 2007. 2 Almost everyone who fractures their hip will be admitted to a hospital, and a large majority will undergo a surgical procedure. In Australia, this means that more than 50 people are admitted every day to a hospital with a hip fracture. 1,3 The individual consequences are significant: 5% of those admitted will die in hospital; over 10% will be discharged directly to an aged care facility; after 12 months, fewer than 50% of people will be walking as well as they did before their injury; and another 15-20% will have died. In addition, the health and social care systems bear considerable costs associated with the acute treatment of hip fractures, ongoing costs of rehabilitation, assistance with day-to- day living activities, and the impact of long term care placement.

    Click the report below to download your copy.

    2016-annual_report

  • Facility Survey 2015

    Facility Survey 2015

    Facility Survey Results - 2014

    FacilitySurvey