Evaluation of the role and impact of ward based Occupational Therapists for older people with hip fractures

Introduction;

Occupational Therapists (OT) play a vital role in the rehabilitation of older people with hip fractures. However a Sheffield Teaching Hospitals 2024 review showed that OT's were spending a significant amount of time completing discharge related admin, reducing face to face contact and opportunities for rehabilitation.

Introduction of the care transfer hub (CTH) to a hip fracture ward in December 2024 was taken as an opportunity to reduce OT discharge administrative duties and re-establish the role of OT's in line with university training, core principles of the profession and job descriptions.

The primary aims of this project were to focus on early goal orientated patient care, improve patients' functional outcomes, improve patient flow and reduce length of stay.

Methods;

The project used an A3 service improvement methodology to establish new roles/responsibilities within the MDT following the implementation of CTH. The focus was on early intervention and functional rehabilitation.

A modified Barthel was completed retrospectively for 30 patients prior to the implementation of CTH and 30 patients afterwards to measure the functional difference.

Data was also collected regarding length of stay and discharge pathways.

The workforce development team completed in depth shadowing of the OT's before and after to establish how the OT role had changed.

Results;

Patient face to face contact time from Occupational Therapy doubled.

After the change of practice, patients were discharged 16.1 points closer to their modified Barthel baseline.

Length of stay decreased by 2.87 days.

More patients were discharged on pathway 0 (40%) than prior to the change of practice (23%). Pathway 1 remained similar. Pathway 2 discharges decreased from 37% of discharges to 23% of discharges.

Conclusion;

Earlier and more frequent Occupational Therapy intervention leads to better functional outcomes, reduced length of stay and reduction in community services requires for hip fracture patients.