Towards an Integrated Person-Centred Care Pathway to Support the Recovery Journey Post Hip Fracture: A Qualitative Study

Abstract

Aim: To explore the pathway of care for people post hip fracture and define what is important for person-centred recovery. Design: Qualitative design using interpretive descriptive methodology, guided by the Health Empowerment theoretical framework. Methods: Semi–structured interviews were conducted from March to October 2021, focussed on the lived experience of recovery post hip fracture. Thirteen participants were interviewed. Five people post hip fracture; four advanced practice nurses and four practice nurses. Data were analysed using thematic analysis. Results: Fragments of hip fracture care was a major theme describing a disconnected pathway following discharge from hospital, and exposed the gap between recommendations for follow up and implementation. Gaps highlighted the need for a key contact clinician to support care coordination, use of individualised care plans, clinical pathways for practice nurses, and follow up post hip fracture. Conclusion: A disconnected recovery pathway was found from the lived experience of hip fracture. Findings highlight opportunities to develop integrated person-centred models of care that empower patients to self-manage their recovery. Implementation of an empowered coordinated pathway with a shared care approach integrates consistent care across the whole patient journey. Implications for the Profession and/or Patient Care: Identified gaps from a fractured recovery formed key components to support a connected care pathway post hip fracture. Linked by the overarching construct of Health Empowerment, policy and practice development embedding a connected pathway within nurse-led models of care should be considered. Reporting Method: Consolidated Criteria for Reporting Qualitative Research. Patient or Public Contribution: No Patient or Public Involvement. Impact: This study explored what was important for recovery post-hip fracture. A fragmented recovery pathway was identified that highlighted key components for improvement. Research supports policy and practice development for nurse-led models of care with an empowered approach post hip fracture.