Hip Fracture - Quality Statement 15: Follow-Up Care

Resources Quality Statements Advisory Committee About

Follow-Up Care

Patients with hip fracture are discharged from inpatient care with a scheduled follow-up appointment with a primary care provider within 2 weeks of returning home and a scheduled follow-up appointment with the orthopaedic service within 12 weeks of their surgery.

Background

A follow-up appointment with a primary care provider within 2 weeks of returning home can help ensure that patients are recovering well from their hip fracture and that any other medical conditions (including osteoporosis) are being managed so that patients can successfully returnto their pre-fracture status. In addition to a primary care follow-up, an appointment with the orthopaedic service should be scheduled within 12 weeks of surgery to allow for an assessment of the outcome of surgery and to facilitate a successful recovery.

What This Quality Statement Means

For Patients

You should have an appointment with a primary care provider within 2 weeks of returning home, plus a follow-up appointment with the hospital’s orthopaedic service within 12 weeks of your surgery.

For Clinicians

Contact your patient’s primary care provider before the patient is discharged from hospital to schedule an appointment within 2 weeks to coordinate transfer of accountability. At discharge, a summary of the patient’s hospital stay should be sent to the primary care provider.

For Health Services

Ensure that systems, processes, and resources are in place to allow all postoperative hip fracture patients to access a follow-up appointment with a primary care provider within 2 weeks of discharge and to access a follow-up appointment with the orthopaedic service within 12 weeks of surgery.

Quality Indicators

Process Indicators

Percentage of hip fracture patients whose primary care provider is contacted before returning home (including primary care providers for long-term care homes) to schedule a follow-up appointment

Denominator: total number of adults admitted to hospital with a primary diagnosis of fragility hip fracture who undergo surgery for hip fracture
Numerator: number of people in the denominator whose primary care provider is contacted before returning home to schedule a follow-up appointment
Data source: local data collection

Percentage of hip fracture patients whose primary care provider (including primary care providers for long-term care homes) receives a discharge summary prior to or at the primary care follow-up appointment

Denominator: total number of adults admitted to hospital with a primary diagnosis of fragility hip fracture who undergo surgery for hip fracture
Numerator: number of people in the denominator whose primary care providers receive a discharge summary prior to or at the patient’s primary care follow-up appointment
Data source: local data collection

Percentage of hip fracture patients who are seen by a primary care provider within 2 weeks of returning home

Denominator: total number of adults admitted to hospital with a primary diagnosis of fragility hip fracture who undergo surgery for hip fracture
Numerator: number of people in the denominator who are seen by a primary care provider within 2 weeks of returning home
Data source: Discharge Abstract Database, Ontario Health Insurance Program (OHIP) claims database

Percentage of hip fracture patients who are seen by the orthopaedic service within 12 weeks of discharge from hospital

Denominator: total number of adults admitted to hospital with a primary diagnosis of fragility hip fracture who undergo surgery for hip fracture
Numerator: number of people in the denominator who are seen by the orthopaedic service within 12 weeks of discharge from hospital
Data source: Discharge Abstract Database, local data collection, Ontario Health Insurance Program (OHIP) claims database

Definitions Used Within This Quality Statement

Orthopaedic service

A hospital’s orthopaedic service consists of a team of health care professionals involved in orthopaedic care; for example, orthopaedic surgeons, nurse practitioners, and physical therapists. At their follow-up appointment with the hospital’s orthopaedic service, hip fracture patients may be seen by any member of the orthopaedic service.

Evidence to Improve Care