ArticlePilot and feasibility studies2026
Feasibility, acceptability, and preliminary effects of PATH FOR timely transfer of geriatric HIP fracture patients from hospital to rehabilitation to home (PATH4HIP): a mixed methods study.
Article in Pilot and feasibility studies, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundHip fractures represent sentinel events in older adults' lives that can lead to a loss of function and permanent disability. Our team developed an evidence-based pathway intervention: PATH FOR timely transfer of geriatric HIP fracture patients from hospital to rehabilitation to home (PATH4HIP). The goal of the pathway is to facilitate early transfer of hip fracture patients to geriatric rehabilitation without having a negative impact on their rehabilitation outcomes. The purpose of this study was to pilot PATH4HIP with post-operative geriatric hip fracture patients during their transition from hospital to rehabilitation to home.
methodsWe conducted a mixed methods feasibility study using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework to evaluate the feasibility, acceptability, and preliminary effects of PATH4HIP. Quantitative data were accessed through administrative databases, and qualitative data were collected from patients, caregivers, and clinicians to report on the five RE-AIM domains.
resultsA total of 317 hip fracture patients were screened between January and September 2022, and 152 met the study eligibility criteria. Reach was achieved, with 77.0% of eligible patients (n = 117) agreeing to participate (progression criteria of ≥ 75.0%). Effectiveness outcomes including rehabilitation length of stay, functional gains, discharge to the community, and 30-day emergency department return rates were comparable to previously reported data for this population. Adoption was also high, with 76.9% of enrolled patients (n = 90) completing the pathway. Implementation was carried out with minimal protocol variations; however, only 48.9% of patients (n = 44) were discharged from acute care by post-operative day 6 (progression criteria of ≥ 75.0%), falling short due to challenges associated with the COVID-19 pandemic. Finally, participants indicated that the PATH4HIP intervention was acceptable, supporting its Maintenance.
conclusionThe study confirmed the feasibility and acceptability of the pathway, while key rehabilitation outcomes were not negatively affected. This pathway design prioritized best practices for hip fracture care and collaboration across health care sectors. This intervention was low cost as it used existing resources to improve use of surgical beds, while enhancing post-surgery hip fracture care. Further research is needed to examine the implementation of this intervention on a larger scale.
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