Enhancing Hip Fracture Patient Care with Allied Health Assistants

Utilising a highly engaged allied health assistant workforce may be the key to providing intensive rehabilitation to an increasing number of people admitted to hospital with a hip fracture.

Peninsula Health’s Senior Allied Health Researcher, Dr David Snowdon, set out to determine the feasibility of allied health assistant rehabilitation of people with a hip fracture in the acute hospital setting to provide an estimate of the effect on guideline adherence and length of hospital stay, compared to rehabilitation delivered by a physiotherapist.

“We are seeing an ageing population, who come to hospital requiring more intensive and complex care,” says Dr Snowdon.

“This means we have a greater demand for our services, and we have to prioritise the work that we do. There are times that demand for our services is so high that we cannot find enough time to provide intensive rehabilitation for every patient who requires it.”

“However, we know that allied health assistants can provide rehabilitation under the supervision of a physiotherapist, such as walking people after surgery.”

“By doing this, the patient still gets that guideline-directed  care from the allied health assistants, freeing up time for  the physiotherapist to rehabilitate other patients.”

“Our previous research at major Victorian hospitals has shown that six to 14 percent of patients with a hip fracture will walk every day of their admission, which isn’t a lot,” explains Dr Snowdon.

The trial had two randomised groups of patients with a hip fracture. One group received daily mobilisation and rehabilitation from a physiotherapist, and the other group received daily rehabilitation and mobilisation from an allied health assistant, under the supervision of a physiotherapist.

“Overall, the findings of the study were that it was feasible for allied health assistants to provide rehabilitation to patients with a hip fracture in the early phase after surgery.”

By utilising the allied health assistant workforce, patients received on average 11 minutes more therapy per day than those who only received rehabilitation from a physiotherapist. The allied health assistant trial group was also more likely to walk on any day and may have had a shorter length of stay in hospital.

Previous research conducted by Victorian health services found that on average, allied health assistants working in acute hospitals spend 24 percent of their day face-to-face with patients. This is a figure that Dr Snowdon says is too low,  and a reason why health services could better utilise their allied health assistants.

“I think we are lucky at Peninsula Health that we have an engaged allied health assistant workforce who have a passion for ensuring that our patients get the best possible care.”

“What we really saw between physiotherapists and allied health assistants during the trial was an authentic open mindset towards working together. There was certainly an understanding that if they can work together, we can see more patients and, in turn, provide a better quality of care.”

“Both the physiotherapists and the allied health assistants were interviewed after the trial, and one of the things that we noticed was that there was really good communication and teamwork.”

Dr Snowdon notes a growing collaboration with allied health assistants, with allied health professionals increasingly incorporating the help of allied health assistants to provide rehabilitation and optimise patient care.

“I think there’s a confidence that it’s safe and that it seems to be just as effective as if a physiotherapist was providing  the rehabilitation, if not more effective,” says Dr Snowdon.

“I think the outcome from this trial will make a difference in starting to see this workforce be utilised more in a clinical setting to provide patient-centred care.”