Implementing the Hip Fracture Toolkit
Through funding provided by Health Canada BJC undertook a project between 2010 – 2013 to work with the provinces across Canada to implement the hip fracture toolkit through a coordinated knowledge translation strategy. Activities within the province included hosting meetings, redeveloping processes, improving patients’ flow and transitions and facilitating access to surgery, rehabilitation and secondary prevention.
The implementation strategy was extremely successful in identifying areas for change and assisting the provinces in improving performance at a local, regional and provincial level. The following provides an overview of the achievements through this National KT Network strategy.
- Gap Analysis and planning for change
All provinces undertook a Gap Analysis to identify opportunities for improvement
Saskatchewan and Prince Edward Island (PEI) completed a formal process that identified barriers and areas for system improvement. Plans were developed for future activity at a local and provincial level.
- Data reporting
Alberta, British Columbia and Ontario developed a provincial system to report data to be used to track performance at a local and provincial level.
PEI increased their capacity for rehabilitation of hip fracture by increasing their efficiencies for hip and knee replacement
Knowledge products to improve care post surgery and optimize recovery and length of stay were developed and implemented in British Columbia, Alberta, Manitoba, New Brunswick, Nova Scotia and Newfoundland
- Surgical performance
Ontario developed tools to support the decision for patients to be weight bearing as tolerated directly following their surgery
- Patient education
Patient educational information was collated to facilitate the development of materials at a local level in each province. Educational initiatives were implemented in BC, Alberta, Ontario, New Brunswick, Quebec, Nova Scotia and Newfoundland. Funding was obtained to develop national booklets through the Canadian Orthopaedic Foundation
Each province identified the need for improved management of osteoporosis and programs were implemented in Manitoba, Quebec, New Brunswick, Nova Scotia and Newfoundland
All provinces achieved their goals to improve care for hip fracture patients and identified that a national approach to the implementation of the best practices in the National Toolkit was key to their success in implementing change. In addition the BJC national hip fracture project resulted in following work being undertaken in the provinces:
- In Ontario a clinical best practice document for hip fracture was developed using the National Hip Fracture Toolkit. This document will be the basis for future funding for hip fracture care.
- In British Columbia provincial funding was made available to develop a hip fracture registry.