ANZHFR 2021 Annual Report

Recommendations

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Indicator 2a: Evidence of local arrangements for timely and effective pain management forhip fracturePAIN PATHWAYIn 2020, the facility level audit showed a protocol or pathway for pain was available at 86% (101/117) of hospitals:64 hospitals for the whole acute journey and 37 hospitals in the Emergency Department (ED) only. These resultsdemonstrate an increase in the overall proportion of hospitals using a pathway with the greatest change in theproportion of respondents reporting a pathway for the whole acute journey.The facility level audit also asks respondents if patients are offered local nerve blocks as part of preoperative andpostoperative pain management. This year, 98% (115/117) responded that patients were offered nerve blockspreoperatively and 86% (101/117) responded that patients were offered nerve blocks for postoperative pain relief‘always’ or ‘frequently’, an increase from 78% in 2019.Indicator 2a: Evidence of local arrangements for timely and effective painmanagement for hip fracturePain pathwayIn 2020, the facility level audit showed a protocol or pathway for pain was available at 86% (101/117) of hospitals: 55%for the whole acute journey and 32% in the emergency department only. These results demonstrate an increase in theoverall proportion of hospitals using a pathway with the greatest change in the proportion of respondents reporting apathway for the whole acute journey.The facility level audit also asks respondents if patients are offered local nerve blocks as part of preoperative andpostoperative pain management. This year, 98% (115/117) responded that patients were offered nerve blockspreoperatively and 86% (101/117) responded that patients were offered nerve blocks for postoperative pain relief‘always’ or ‘frequently’, an increase from 78% in 2019.FIGURE 4 Pain pathway reported as an element of careFigure in Australia 4 – Pain pathway and New reported Zealand as an 2O13-2O2Oelement of care in in Australia and New Zealand 2013-20201009080% proportion of hospitals7060504030201002013 2014 2015 2016 2017 2018 2019 2020Year24 ANNUAL REPORT 2021 / ANZHFRPain pathway (NZ)Pain pathway (AUS)
Indicator 2b. Proportion of patients with a hip fracture who have documented assessmentof pain within 30 minutes of presentation to the Emergency Department and either receiveanalgesia within this time or do not require it according to the assessmentOn average, 62% of New Zealand hip fracture patients and 66% of Australian hip fracture patients, respectively,had a documented assessment of pain within 30 minutes of presentation (Figure 5). Pain assessment in the ED hasincreased each year in New Zealand, and overall Figure in Australia 5 – Pain since assessment 2017. in the Emergency Department (ED)re 5 – Pain assessment Figure in 5 the – Pain Emergency assessment Department in the Emergency (ED) Department (ED)Avg 2017Avg 2018Avg 2019Avg 2020WREHKBNSHWAGWHKBHEACHTGAHUTPMRGISMMHMROTARROTNSNTIUWKOINVCHCDUNWLGNZ Avg 2017FIGURE 5 Pain assessment in the Emergency Department (ED)NZ Avg 2017NZ Avg 2018NZ Avg 2019NZ Avg 2020WREHKBNSHWAGWHKBHEACHTGAHUTPMRGISMMHMROTARROTNSNTIUWKOINVCHCDUNWLGNZ Avg 2018NZ Avg 2019NZ Avg 2020WREHKBNSHWAGWHKBHEACHTGAHUTPMRGISMMHMROTARROTNSNTIUWKOINVCHCDUNWLGAus Avg 2017Aus Avg 2018Aus Avg 2019Avg 2017Aus Avg 2017Aus Avg 2020Avg 2018Aus Avg 2018H04Avg 2019Aus Avg 2019TSVABAAvg 2020Aus Avg 2020RNSTNHH04H04TAHTSVTSVROBABAABACFSRNSRNSLOGTNHTNHPMBTAHTAHH03ROBROBLBHCFSCFSTWHLOGLOGCAMPMBPMBH05H03H03CRGLBHLBHLGHTWHTWHRHHCAMCAMSCUH05H05SVDCRGCRGMARLGHLGHTWBRHHRHHH06SCUSCUCNSSVDSVDTAMMARMARLMHTWBTWBGOSH06H06ROKCNSCNSPCHTAMTAMQIILMHLMHRPAGOSGOSGCHROKROKSTGPCHPCHOHSQIIQIIPAHRPARPAQEHGCHGCHIPSSTGSTGSCGOHSPAHOHSJHCQEHPAHRAHIPSQEHDDHSCGIPSBOXJHCSCGPOWRAHJHCMSBDDHRAHFMCBOXDDHWMDPOWBOXARMMSBPOWNEPFMCMSBH07WMDFMCWGGARMWMDRPHNEPARMHKHH07NEPDBOWGGH07REDWGGFOORPHHKHRPHTSHDBOHKHTMHREDDBOJHHFOOREDBKLTSHFOOFSHTMHTSHH01JHHTMHLIVBKLJHHH02FSHBKLFRAH01FSHLIVH010% 10% 20% 30% 40% 50% 60% 70% 80% 90H02LIVFRAH02FRADocumented assessment of pain within 30 minutes of ED presentation0% 10% 20%0%30%10%40%20%50%30%60%40%70%50%80%60%90%70%100%80% 90% 100%Documented assessment of pain greater than 30 minutes of ED presentationDocumented assessment of painDocumentedwithin 30 minutesassessmentof ED presentationof pain within 30 minutes ofPainEDassessmentpresentationnot documented or not doneDocumented assessment of painDocumentedgreater thanassessment30 minutes ofofEDpainpresentationgreater than 30 minutesNot knownof ED presentationPain assessment not documentedPainorassessmentnot donenot documented or not doneNot knownNot known25
Page 1 and 2: ANNUALREPORT2O21
Page 3 and 4: CONTENTS2 ABBREVIATIONS4 CO-CHAIRS
Page 5 and 6: The 2021 report provides the larges
Page 7 and 8: Whilst 90% of patients werereported
Page 9 and 10: FACILITY LEVEL REPORT91%of hospital
Page 11 and 12: ANZHFRPARTICIPATIONHospitals in Aus
Page 13 and 14: The patient level report includes d
Page 15 and 16: QUALITY STATEMENT 4:Timing of surge
Page 17 and 18: QUALITYSTATEMENT 1Care atpresentati
Page 19 and 20: Indicator 1a: Evidence of local arr
Page 21 and 22: Indicator 1b: Proportion of patient
Page 23: QUALITYSTATEMENT 2PainmanagementA p
Page 27 and 28: COLLABORATING TO ENHANCE HIP FRACTU
Page 29 and 30: COVID’S IMPACT AT FRANKSTON HOSPI
Page 31 and 32: FIGURE Figure 8 8 - Assessed by ger
Page 33 and 34: Indicator 4a: Proportion of patient
Page 35 and 36: GOSFORD - TIME TO SURGERY AND THEAT
Page 39 and 40: FIGURE 12 Actual first day mobilisa
Page 41 and 42: Indicator 5b: Proportion of patient
Page 43 and 44: Indicator 5d: Proportion of patient
Page 47 and 48: Our hospital’s storydemonstrates
Page 49 and 50: Indicator 7a: Evidence of local arr
Page 51 and 52: 7b. Proportion of patients with a h
Page 53 and 54: FIGURE 21 Australian hospital data
Page 55 and 56: The outlier report monitorshospital
Page 57 and 58: FIGURE 24 Adjusted mortality rate a
Page 59 and 60: FIGURE 28 Funnel plot of adjusted m
Page 61 and 62: FIGURE 32 Funnel plot of adjusted m
Page 63 and 64: 0% 10% 20% 30% 40% 50% 60% 70% 80%
Page 65 and 66: SAAus Avg 2019NSWTASAus Avg 2020VIC
Page 67: THANK YOU TO ALLTHE TEAMS WORKINGAC

ANZHFR 2021 Annual Report

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