Project objectives

The ACI had identified significant benefits to both consumers and the health care system of evidenced-based hip fracture management in the elderly. These included improved morbidity and mortality, better functional outcomes, increased rates of discharge to original place of residence, and increased value from health dollars spent.

The objectives of the evaluation were to:

  • Assess the soundness of the Minimum Standards (including the evidence base and support for them by clinicians), the governance processes supporting the Standards and associated tools and guidelines.
  • Examine consumer outcomes associated with the implementation of the Minimum Standards.
  • Articulate barriers and success factors for implementation.

NSW Agency for Clinical Innovation

Our approach

We developed a program logic and evaluation framework, and data collection instruments. The evaluation was of the ‘program’ as whole (which included the evidence base and support for the Minimum Standards, governance, and associated tools and guidelines), and of the implementation of the Standards at six selected hospitals within NSW. The hospitals included three where the implementation was well advanced and three where it was in early stages. Selected early impact/outcome measures were compared between the hospitals.


The evaluation found evidence of positive patient outcomes associated with the implementation of the Minimum Standards and reduction in length of stay.

The report set out the key enablers for effective implementation, which included clinical and management leadership, hospital-wide implementation, sufficient volume of activity and access to information on patient indicators and comparative hospital performance. The barriers included lack of availability of follow up/extended services, initiatives being person-dependent, IT and data limitations and competing state and local priorities.

Recommendations for refining the Minimum Standards were provided for the ACI to consider.

Our vision

HPA aims to be a leading firm in specialist consulting services in the health care sector, offering qualitative and quantitative analysis and synthesis of evidence, providing expertise in statistics and data science, and contributing to well founded and practical policy advice. We aim to deliver the highest quality of services, helping our clients to achieve their objectives, while transferring our expertise and building their capabilities.

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