Evidence map›Paper›PMID 38350882›Full record

ArticleBMC geriatrics2024

Boosting inpatient exercise after hip fracture using an alternative workforce: a mixed methods implementation evaluation.

Marie K March, Sarah M Dennis, Sarah Caruana, Christopher Mahony, James M Elliott, Stephanie Polley, Bijoy Thomas, Charlie Lin, Alison R Harmer

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC geriatrics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Marie K MarchPhysiotherapy Department, Blacktown Mt Druitt Hospitals, Western Sydney Local Health District, Blacktown, NSW, Australia. Marie.March@health.nsw.gov.au.
Sarah M DennisSydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia.
Sarah CaruanaPhysiotherapy Department, Blacktown Mt Druitt Hospitals, Western Sydney Local Health District, Blacktown, NSW, Australia.
Christopher MahonyPhysiotherapy Department, Hornsby Ku-ring-gai Hospital, Northern Sydney Local Health District, Hornsby, NSW, Australia.
James M ElliottSydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia.
Stephanie PolleyDepartment of Rehabilitation and Aged Care, Blacktown Mt Druitt Hospitals, Western Sydney Local Health District, Blacktown, NSW, Australia.
Bijoy ThomasDepartment of Orthopaedic Surgery, Blacktown Mt Druitt Hospital, Western Sydney Local Health District, Blacktown, NSW, Australia.
Charlie LinDepartment of Orthopaedic Surgery, Hornsby Ku-ring-gai Hospital, Northern Sydney Local Health District, Hornsby, NSW, Australia.
Alison R HarmerSydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia.

Funding

Sydney Health Partners Implementation Science GrantWestmead Charitable Trust Allied Health Career Development Grant
6 · The paper itself

Abstract

backgroundHip fracture has a devastating impact on individuals and is an increasing burden for health systems and society. Compared to usual care, increased physiotherapy provision has demonstrated efficacy in improving patient and health service outcomes in this population. However, physiotherapy workforce challenges prevent sustained implementation.

methodsOur aim was to evaluate the safety, feasibility, acceptability, effectiveness and implementation cost of thrice daily physiotherapy for patients in the acute care setting after hip fracture at two public hospitals. We added twice-daily exercise implemented by an alternative workforce, to usual care consisting of daily mobility practice by a physiotherapist. Sites identified their preferred alternative workforce, with pre-registration physiotherapy students and allied health assistants chosen. We used a mixed methods approach, using the Consolidated Framework for Implementation Research (CFIR) as a determinant framework to guide implementation planning and data collection. We compared hospital length of stay data to a reference cohort.

resultsWe recruited 25 patients during the study period. Acute care hospital length of stay decreased from 11 days in the reference cohort to 8 days in the BOOST cohort (mean difference - 3.3 days, 95%CI -5.4 to -1.2 days, p = 0.003). Intervention fidelity was 72% indicating feasibility, no safety concerns were attributed to the intervention, and uptake was 96% of all eligible patients. The intervention was acceptable to patients, carers and healthcare providers. This intervention was cost-effective from the acute orthopaedic service perspective.

conclusionHigher daily frequency of physiotherapy can be safely, feasibly and effectively implemented by an alternative workforce for patients in the acute care setting following hip fracture surgery.

Indexed as

Hip FracturesInpatientsPhysical Therapy ModalitiesExerciseHumansImplementation ScienceWorkforceHealth services researchHip fractureImplementation scienceMixed methods researchPhysical therapyPhysiotherapyWorkforce

Identifiers

PMID38350882
PMCPMC10865645

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.