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Evidence to Improve Care

13

Rehabilitation

Patients with hip fracture participate in an interdisciplinary rehabilitation program (in an inpatient setting, a community setting, or a combination of both) with the goal of returning to their pre-fracture functional status.


On discharge from the acute care hospital, all hip fracture patients—including patients with cognitive impairment and those residing in long-term care homes—should have the opportunity to participate in an active interdisciplinary rehabilitation program. Rehabilitation programs have been shown to improve patient outcomes, including but not limited to functional status, leg strength, health status, balance, mobility, instrumental activities of daily living, and social functioning.

For Patients

When you leave the hospital, you should be offered a rehabilitation program to help get you back to the activities you were able to do before your fracture.


For Clinicians

Provide a rehabilitation program to your hip fracture patients that includes therapies to improve independence in self-care, balance and gait assessment and training, nutritional supplementation, education on safety and fall prevention, a restorative and/or maintenance exercise program, environmental modifications, osteoporosis management and education, and medication management.


For Health Services

Ensure that systems, processes, and resources are in place to allow all hip fracture patients, regardless of cognitive impairment or setting, to participate in a rehabilitation program following surgery.

Process Indicators

Percentage of hip fracture patients who participate in a postoperative interdisciplinary rehabilitation program

  • 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 participate in a postoperative interdisciplinary rehabilitation program

  • Data source: Continuing Care Reporting System, Discharge Abstract Database, Home Care Database, National Rehabilitation Reporting System, local data collection

Median number of days after surgery that hip fracture patients begin a rehabilitation program

  • Data source: Continuing Care Reporting System, Discharge Abstract Database, Home Care Database, National Rehabilitation Reporting System, local data collection

Rehabilitation program

An effective hip fracture rehabilitation program includes the following:

  • Therapies to improve independence in self-care

  • Balance, strengthening, and gait assessment and training

  • Nutritional supplementation

  • Education on safety and fall prevention

  • Environmental modifications

  • Osteoporosis management and education

  • Medication management

  • Pain management education

  • Positioning education for comfort and pressure relief

  • Transfer training

  • Stair training

  • An ongoing exercise program following completion of formal rehabilitation

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