Hip Fracture Across Alberta

From transport by EMS through to surgery and discharge from hospital—for any Albertan with a hip fracture this care journey is optimized.


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Statistical improvements from a short 3-month pilot of a new acute hip fracture pathway were underwhelming. Yet the potential benefits for Albertans were evident to the clinical and operational leaders of the Bone and Joint Health Strategic Clinical Network’s project (link to Acute HF Pathways Pilot case study above)

Problems to Solve

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  • More actively support sites in implementing the pathway and materials


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Alongside a provincial task force from the Bone and Joint Health Strategic Clinical Network, we set out to enhance the new acute hip fracture pathway and support implementation across the province. Measurement tools helped hospital sites monitor multiple dimensions of care and quality. Provincial metrics focused on processes and outcomes such as time to surgery, early mobilization post-surgery, delirium management, length of stay in hospital, discharge planning, re-admissions, and refractures. Site-by-site data comparisons encouraged collaboration and learning amongst provincial partners. Site audits we conducted helped determine root causes of variance from the pathway. We then supported local teams in developing action plans to close gaps in their performance results. Learning from best practice and new evidence, we supported evolution of the pathway and materials over time.

Tangible Outputs

  •  Clinical pathway
  • Pre-op and post-op orders
  • Teaching materials
  • Measurement framework
  • Balanced scorecards
  • Key performance indicator reports
  • Variance assessments


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For every 1,000 hip fractures in Alberta, over 12 lives are saved. The provincial efforts of all involved resulted in better quality, better outcomes, and better value.