Boosting inpatient exercise in western Sydney after hip fracture

This month, Blacktown and Mt Druitt Hospitals senior physiotherapist, Marie March, spoke about the ‘Boost Project’ on Hipcast, the Australian and New Zealand Hip Fracture Registry podcast to improve hip fracture care.

Marie is the chief investigator for the Boost Project, which has been exploring how hospitals can deliver more frequent exercise programs for inpatients with hip fracture through an implementation science study with physiotherapists and other healthcare workers.

The project is supported by an implementation science grant from Sydney Health Partners and the results of the first trial are currently being finalised for publication.

Listen to the podcast here

“The first 10-week Boost Project study investigated whether we can use an alternate workforce to implement high frequency physio, supervised by physios,” explained Marie.

“Thanks to the work of Victorian-based senior physiotherapist, Dr Lara Kimmel, we know that high frequency physio in the acute setting improves overall hospital length of stay.

“We wanted to replicate those findings, but account for our differences in physio service provision, and see if high frequency exercise using an alternate workforce in patients after hip fracture was safe, acceptable, feasible, effective and cost effective.

The project team recruited patients who after a hip fracture had operative fixation and got the hospital sites to choose who would be the alternate workforce and what training needs they would have.

Both sites chose to use pre-registration physiotherapy students who provided high frequency intervention on the weekdays with opportunistic intervention on the weekends.

“Our early findings and patient outcomes were really encouraging, said Marie.

“Our acute hospital length of stay, which is our primary outcome measure, improved to seven days, from the reference cohort of nine to 10 days.

“Our variation improved as well; from seven to 14 days to five to 11 days.

“We had no safety concerns and patients, staff, carers and management reported positive experiences and were really satisfied with the study.”

After the results of the study are released in the coming months, Marie and the team are hoping to reproduce boost in other settings – particularly rural settings.

“There’s a lot of flexibility with the way that we’ve done these implementations. There’s a lot of future possibilities to explore,” said Marie.