Why Should I Know About Hip Fracture and ECHO

Older adults living with frailty are more likely to experience issues with bone health.

This means that older adults living with frailty are more likely to be diagnosed with osteoporosis, are more likely to experience a fracture, and/or have a higher risk of future fractures. As well, osteoporosis can affect the rate at which frailty advances. Older adults who experience a fracture have an increased risk of frailty. If an older adult living with frailty experiences a fracture, they are at an increased risk of developing more severe frailty.”

In 2024, Ontario Health released an updated Quality Standard focused on Hip Fracture, with a specific focus on the care of individuals with fragility fractures. Quality standards describe key characteristics of high-quality care that should be received and are developed for the purpose of improving consistency of care across the province. Fragility hip fractures are fractures of the femur caused by low energy trauma, such as falls from a standing height. This standard focuses on those age 50+ undergoing surgery for fragility hip fractures (versus hip fractures resulting from high energy trauma). The time frame of the standard is from presentation in the Emergency Department (ED) to 3 months post-surgery. The standard includes fifteen quality care statements related to: care in the ED, surgically and post-operatively; rehabilitation management; pain management; delirium screening; and, follow-up care.

According to the standard, about 12,000 people in Ontario experience a hip fracture every year.  Fragility hip fractures typically occur in older adults living with osteoporosis and other co-morbidities. It is estimated that about 20% of those suffering a hip fracture will die within a year, 20% who had been previously independent will require LTC admission, and more than 50% of those previously independent will require a mobility aid.   

To support successful adoption of the standard across the province, an ECHO Orthogeriatric (OG) Program is being led by Dr Jenny Thain, a Geriatrician at St Joseph’s Health Care in London. Project ECHO is a continuing medical education program that engages clinicians virtually and provides an opportunity for education, support, guidance and feedback. ECHO OG includes 90-minute sessions with time dedicated to education, discussion and case study.  Participants are encouraged to submit anonymized clinical cases that they find have found interesting or challenging. At the end of the session, the ECHO OG Hub team will provide written feedback to clinicians in response to the cases they have submitted. 

This ECHO program has just started so there still is time to register. Anyone interested in ECHO OG is encouraged to find out more and, if interested, register at the following link:  https://iecho.org/public/program/PRGM17315524156283WOFCYWNUH

Article submitted by:

Monica Menecola, Regional Integration Lead, Simcoe County and Muskoka, Ontario Osteoporosis Strategy

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