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Fitzgerald M1, Callanan E2, Blake C3, Brent L4, Hurson C5, Ahern E6, Cunningham C3
1Tallaght Hospital, Physiotherapy, Dublin, Ireland, 2Merlin Park Hospital, Galway, Ireland, 3University College Dublin, Dublin, Ireland, 4National Office of Clinical Audit, Dublin, Ireland, 5St Vincent's Hospital, Dublin, Ireland, 6St Luke's Hospital, Kilkenny, Ireland
Background: Although overall outcomes post hip fracture have been improving recently, functional outcomes are poor, with hip fracture rehabilitation recognised as a central challenge in trauma services. A key strategy in improving hip fracture outcome is the implementation of national hip fracture databases, allowing health services to monitor standards of care. However, national databases often lack information regarding physiotherapy service provision and functional outcomes. This impairs the ability of health services to profile functional outcomes, assess barriers to rehabilitation and evaluate the impact of organisation improvements in hip fracture care on functional outcome. The Irish Hip Fracture Database (IHFD) was established in 2013 with a paucity of rehabilitation or functional outcome data.
Purpose: Aim - Incorporate evidence-based rehabilitation focussed data-fields into the IHFD.
Methods: The IHFD governance committee has 11 multidisciplinary members including health and social care. In 2015 a physiotherapy working group was established to examine the potential for inclusion of physiotherapy focussed datafields. This group comprised clinical, managerial and academic members. A pilot study identified feasible, evidence-based functional measures that could be implemented in a clinical setting, and be prognostically important. Using the Adapte process for guideline adaptation, an international guideline review informed physiotherapy service indicators.
Results: The proposed new measures were reviewed by the IHFD governance committee and the following 5 new fields were added to the IHFD from 1st January 2016 following engagement and education of physiotherapists, physiotherapy managers and IHFD data-collectors in the 16 trauma orthopaedic sites nationally.
· Day one postoperative physiotherapy assessment:Yes/No
· Day one postoperative mobilisation:Yes/No
· Prefracture function:New Mobility Score(Score 0-9)
· Function day one postoperatively and day of acute hospital discharge:Cumulated Ambulatory Score(Score 0-6).
Conclusion(s): Rehabilitation data-fields were successfully added to the 2016 IHFD, enabling accurate profiling of Irish physiotherapy service provision and functional outcome post hip fracture. These data will be presented in the 2016 IHFD report.
Implications: Continued commitment to rehabilitation focussed data collection will enable evaluation of hip fracture service enhancements on functional outcome.
Keywords: Hip Fracture, Rehabilitation, Clinical Audit
Funding acknowledgements: Nil
Purpose: Aim - Incorporate evidence-based rehabilitation focussed data-fields into the IHFD.
Methods: The IHFD governance committee has 11 multidisciplinary members including health and social care. In 2015 a physiotherapy working group was established to examine the potential for inclusion of physiotherapy focussed datafields. This group comprised clinical, managerial and academic members. A pilot study identified feasible, evidence-based functional measures that could be implemented in a clinical setting, and be prognostically important. Using the Adapte process for guideline adaptation, an international guideline review informed physiotherapy service indicators.
Results: The proposed new measures were reviewed by the IHFD governance committee and the following 5 new fields were added to the IHFD from 1st January 2016 following engagement and education of physiotherapists, physiotherapy managers and IHFD data-collectors in the 16 trauma orthopaedic sites nationally.
· Day one postoperative physiotherapy assessment:Yes/No
· Day one postoperative mobilisation:Yes/No
· Prefracture function:New Mobility Score(Score 0-9)
· Function day one postoperatively and day of acute hospital discharge:Cumulated Ambulatory Score(Score 0-6).
Conclusion(s): Rehabilitation data-fields were successfully added to the 2016 IHFD, enabling accurate profiling of Irish physiotherapy service provision and functional outcome post hip fracture. These data will be presented in the 2016 IHFD report.
Implications: Continued commitment to rehabilitation focussed data collection will enable evaluation of hip fracture service enhancements on functional outcome.
Keywords: Hip Fracture, Rehabilitation, Clinical Audit
Funding acknowledgements: Nil
Topic: Research methodology & knowledge translation; Service delivery/emerging roles; Service delivery/emerging roles
Ethics approval required: No
Institution: Tallaght University Hospital
Ethics committee: St James's Hospita/Tallaght University Hospita Ethics Committee
Reason not required: describes innovative ways that methods have been adapted to the changing needs of clinical practice
All authors, affiliations and abstracts have been published as submitted.
