Orthogeriatric Services Self-Assessment Questionnaire

Orthogeriatric Services Self-Assessment Questionnaire

Please complete each section using concise, evidence-based answers. Where possible, include supporting documents, links, and measurable outcomes so your submission is ready for review and reporting.
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Evidence link
Responsible person
Detailed timeline
Reviewer comments
How to complete this self-assessment
Please Provide Your First and Last Name:
Please Provide Your Email Address:
In order to fully assess the program we need to review the documents that support your clinical care. These can be submitted in the form or sent to operations@fragilityfracturenetwork.org. If these are copyrighted we will destroy them after review.

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A. Organizational Information

Rows	Organization Information
Organization Name
Organization Address
Type of Organization: e.g. Acute Care: Academic, Community, Rehabilitation, Long Term Care
Size of Hospital: # Patients Total
Description of Units: Dedicated Orthogeriatric, Trauma, Orthopaedic, Surgical, Medical, Other
Services Provided: Emergency Surgery Post Op, Stabilization Post Op, Recovery Rehabilitation
Transitions from or to other organizations for components of the care. Please identify all models as there may be more than one. e.g. 1. Receive patient from outlying hospitals to surgical hospital 2. Discharge to a rehabilitation unit as soon as medically stable
Are there any national documents, standards and/or audits? If so, how does your organization rate within these standards? Provide a link to any relevant documentation
Other Information Relevant to the Application

Application Submitter

Rows	Answers
Name
Position
Email

I consent to the use of AI-assisted tools to review and analyze the information I provide in this form.

B. Questionnaire

Section 1: Identification of Fragility Fracture Patients
B. FFN Scoring

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0 is Worst, 3 is Best
Self-Assessment Questions

How many patients with the following fractures as a result of low impact injuries are admitted to your organization each year?

Rows	Number	1-20	21-50	51-100	101-200	Over 200
Hip
Other Femoral (Subtrochanteric, Periprosthetic)
Pelvis
Vertebral
Other
All Fractures (If Numbers Above Not Known)

What percentage of these patients with the following fractures as result of low impact injuries receives access to orthogeriatric care in your organization each year? (Approximate) Please Indicate if you cannot answer this question.

Rows	Percentage
Hip
Other Femoral Fractures (Subtrochanteric)
Periprosthetic
Pelvis
Vertebral
Other
Notes

Identify any organizational structures that are in place to help manage and care for these patients e.g. orthogeriatric units, assigned beds.
How is the Orthogeriatric service notified of a patient who needs to be admitted to the service?
Plans to Improve
Provide information on any activities that are planned over the next 1 – 2 years to address limitations you have identified in the self-assessment of this section including status and timelines.

Rows	Answers
Which department/s is the data reported to?
Is there a group responsible for the data that includes representatives from all the departments? E.g. working group or quality committee?
How is the data reported to all team members? E.g. report, presentation at meetings
How often is the data reported to team members?
Is any of the data reported to patients, carers or the public?

Standard 4: Multidisciplinary Team and Access to Geriatric Expertise
FFN Scoring

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0 is Worst, 3 is Best
Self-Assessment Questions

What is the role of each of the team members in your service/unit? In your answer identify: 1. Who takes the lead on: a. The care of the frailty, comorbidities and other health conditions, b. Secondary prevention – osteoporosis medication, falls assessment and prevention: 2. Where relevant, if there are professionals with advanced knowledge in the management of older adults e.g. advanced practice nursing, physiotherapy.

Rows	Answers
Orthopaedic Surgeon
Geriatrician/ Orthogeriatrician
General Physician, Internal Medicine
Anaesthesiologist
Rehab Medicine
Nursing
Advanced Practice/ Extended Scope Nursing/Allied health Professional
Physiotherapists
Occupational Therapists
Dietician
Health Care Support Worker
Other

How is planned care communicated within the multidisciplinary team to ensure the patient is progressing and that any complications are addressed? Provide the process and timelines (e.g. daily, weekly).

Rows	Answers
Process and timelines for access to initial and ongoing assessments by physician or geriatrician
Documentation by nurses and allied health to identify and address issues
Documentation by physician to identify and address issues
Other

How is care coordinated within the multidisciplinary team to ensure the patient is progressing and there is a discharge plan? Provide the process and timelines (e.g. daily, weekly).

Rows	Answers
Daily staff meetings for handover
Regular multidisciplinary rounds with geriatrician/physician present
Regular interdisciplinary meetings focused on patient goals
Documentation to identify and address issues
Meetings with patients/carers/families to review progress and discuss progress/plans/discharge
Discharge planning with additional team members
Other

How does each of the MDT support the mobilizing of the patient?

Rows	Day 0/1 First Time Up	Daily	Weekends
Physician
Physio
Nurses
Family
Carer
Support Worker

Nutrition subsection: How does each of the MDT ensure the patient has ingested sufficient nutrition for enhance recovery?

Rows	Answer
Physician
Physio
Nurses
Family
Carer
Support Worker

Nutrition subsection: What proportion of hip fracture inpatients who remain malnourished or at risk of malnutrition do you think have a post-discharge plan?
Plans to Improve
Provide information on any activities that are planned over the next 1 – 2 years to address limitations you have identified in the self-assessment of this standard including status and timelines.
Nutrition subsection: Is your hospital / health service doing anything to improve the ingestion of sufficient nutrition? If yes, please share one or more single sentence examples or what seems to work well.
SIMPLER strategies are usually not complicated. They can take many forms - for examples audits, shared roles, routines, education or training, cues or reminders, policy changes, technology tools, or improvements to the care environment.

Standard 5: Multidisciplinary Team Education
FFN Scoring

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0 is Worst, 3 is Best
Upload staff education materials or training evidence

Include agendas, slide decks, attendance sheets, or promotional materials.
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Self-Assessment Questions

What education on managing/caring for patients with a fragility hip fracture is provided to the multidisciplinary team on the unit? Include the format, length (Number of hours) and the timelines it is available for each multidisciplinary member, e.g. weekly, every 3 months.

Rows	Answers
Do you have a process to identify the learning needs and track the learning progress for the Multidisciplinary Team Members?
Basic Level for all Multidisciplinary Team Members Including Personal Assistants
Intermediate Education for Health Care Professionals e.g. Nursing, Rehab, Dieticians
Specialized Education for Physicians and/or Extended Nurse Practitioners
Other

Provide information on the education available to team members who work on other units.
Plans to Improve
Provide information on any activities that are planned over the next 1 – 2 years to address limitations you have identified in the self-assessment of this standard including status and timelines.

Standard 6: Patient and Family-Centred Goal Setting and Care Planning
FFN Scoring

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3

0 is Worst, 3 is Best
Self-Assessment Questions

What is the formal process for setting goals for the patient including discharge plans? Identify which health care professionals are responsible (provide activities, responsibilities and timelines).

Rows	Answers
Assess the Social Situation
Make the Discharge Plan with the Patient and Carers
Clearly Identify the Goals so they are Available to the Healthcare Team
Process for all Multidisciplinary Team Members to Focus on Goal Attainment
Identify Community Resources and Make Recommendations
Coordinating the Final Discharge
What Happens When a Patient Cannot Return Home
Other

Goal entry, alignment, and documentation.

Rows	Process	MDT Responsible
Identify how the goals are entered into the health record so they are available to the MDT
Identify how the MDT align and document their treatment to achieve the discharge goals

Nutrition subsection: What proportion of all hip fracture inpatients (or carers where appropriate) do you think are aware of their nutrition risk status?
Plans to Improve
Provide information on any activities that are planned over the next 1 – 2 years to address limitations you have identified in the self-assessment of this standard including status and timelines.
Nutrition subsection: Is your hospital / health service doing anything to improve "Aware of nutrition risk status?" If yes, please share one or more single sentence examples of what seems to work well.
SIMPLER strategies are usually not complicated. They can take many forms - for examples audits, shared roles, routines, education or training, cues or reminders, policy changes, technology tools, or improvements to the care environment.

Standard 7: Patient and Carer/Family Education
FFN Scoring

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3

0 is Worst, 3 is Best
Upload patient and carer education materials or resource links

Attach documents and include any online resources used.
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Self-Assessment Questions
What standard written/video materials are provided for patient and carer education?e.g. booklets, videos.
What is the process for providing patient and carer personal education on an individual basis including who is responsible?
Nutrition subsection: What proportion of all hip fracture inpatients (or carers where appropriate) do you think have received nutrition information (written or verbal)?
Nutrition subsection: How do you encourage good nutrition in hospital?
How do you encourage ongoing progression of function including post discharge? (e.g. long term goal setting)
Plans to Improve
Provide information on any activities that are planned over the next 1 – 2 years to address limitations you have identified in the self-assessment of this standard including status and timelines.
Nutrition subsection: Is your hospital / health service doing anything to improve "received nutrition information?" If yes, please share one or more single sentence examples of what seems to work well.
SIMPLER strategies are usually not complicated. They can take many forms - for example audits, shared roles, routines, education or training, cues or reminders, policy, technology tools, or improvements to the care environment.

Standard 8: Secondary Prevention Protocols
FFN Scoring

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3

0 is Worst, 3 is Best
Self-Assessment Questions

What is the formal process for patients to have access to secondary prevention including maximizing recovery, falls and osteoporosis medication? (Provide activities, responsibilities and timelines and specify any issues with access).

Rows	Answers
Do you start osteoporosis medication in the hospital for some patients? Provide criteria and medication provided
Do you refer to a coordinated service to manage Secondary prevention such as a Fracture Liaison Service?
How do you coordinate access to Osteoporosis medication?
How do you coordinate Falls assessment and prevention?
Do you provide a follow up clinic visit after discharge where referrals can be made to community services?
How do you support ongoing post discharge functional recovery through exercise and function to optimize recovery?
Nutrition subsection: How do you support ongoing post discharge functional recovery through nutrition?
Notes

Plans to Improve
Provide information on any activities that are planned over the next 1 – 2 years to address limitations you have identified in the self-assessment of this standard including status and timelines.
Nutrition subsection: Is your hospital / health service doing anything to improve "post discharge planning?" If yes, please share one or more single sentence examples of what seems to work well.
SIMPLER strategies are usually not complicated. They can take many forms - for example audits, shared roles, routines, education or training, cues or reminders, policy, technology tools, or improvements to the care environment.

Rows	Yes	No	Notes:
Assessments and Consultations
Tests and Lab Work
Medication Reconciliation
Weight Bearing Status (Weight Bearing as Tolerated)
Mobilization Day 0 or Day 1 Post-surgery
Daily Mobilization by all MDT
Nutrition and Hydration, Assessment and Treatment
Delirium Prevention
Pressure Injury Prevention

Rows	Staff	Care
Medical Staff
Nursing
Rehabilitation (Day 0/1 Mobilization, Daily Mobilization)
Access to the OR

Rows	What is Collected?	What is Your Performance? Provide Recent Numbers	Do You Want to Improve? Provide Target
Demographics: Sex, Age
Pre-Fracture Status: Residence, Mobility/ADLs, Cognitive Status
Date and Time Patient Presented with Hip Fracture at Operating Hospital
Fracture: Type, Side, Pre-fracture Mobility/ADLs, Pathological
Surgery: % Admissions(98%), ASA, Type, Date/Time ( 48 hours), Anaesthesia
Mobilization: Weight Bearing Status *Unrestricted 99%, Day 1 Activity, Regular Mobilization (Level, Frequency, Progression), ADL/Return to Function
Specialized Multidisciplinary Team Involvement: e.g. Trained Nnurses, Geriatrician
Complications: Pressure Ulcers, Delirium *Zero
Outcomes: In Hospital Death, Discharge Date and Location
In Hospital Secondary Prevention: Falls, Osteoporosis Medication
Community Outcomes at 30 Days: Readmission, Mortality, Return to Function, Secondary Prevention (Osteoporosis, Falls)
Other

Rows	What do you collect?	Where do you get the data from?	Percentage of patient data captured on
Pre-surgery: Demographics (Sex, Age)
Pre-fracture status: Residence, mobility/ADLs, cognitive status
Date and time patient presented with hip fracture at operating hospital
Fracture: type, side, pathological
Surgery and post op care: ASA, type, anaesthesia
Specialized multidisciplinary team involvement (trained nurses, geriatrician)
In hospital secondary prevention: Falls
Osteoporosis medication
In hospital outcomes: in hospital death
Discharge date and location
30 days outcomes: Readmission
Return to function
Mortality
Osteoporosis Ax/Tx
Falls Ax
Other

Rows	What is collected?	Where do you get the data from?	What is your performance? (Provide recent numbers)	Do you want to improve? (Provide target)
Surgery: % admissions (*98%)
Date/Time (*48 hours)
Anaesthesia (Regional)
Mobilization: Weight bearing status (*Unrestricted 99%)
Day 0/1 mobilization
Daily mobilization
Met functional goals at discharge
Complications: Pressure ulcers (*zero)
Delirium (*zero)
In hospital secondary prevention: Started on osteoporosis medication
Other

Orthogeriatric Services Self-Assessment Questionnaire

B. Questionnaire

Self-Assessment Questions

Plans to Improve

Standard 2: Evidence Based Clinical Care from Admission to Discharge

Self-Assessment questions

Plans to Improve

Standard 3: Audit and Performance Monitoring

Self-Assessment Questions

Plans to Improve

Standard 4: Multidisciplinary Team and Access to Geriatric Expertise

Self-Assessment Questions

Plans to Improve

Standard 5: Multidisciplinary Team Education

Self-Assessment Questions

Plans to Improve

Standard 6: Patient and Family-Centred Goal Setting and Care Planning

Self-Assessment Questions

Plans to Improve

Standard 7: Patient and Carer/Family Education

Self-Assessment Questions

Plans to Improve

Standard 8: Secondary Prevention Protocols

Self-Assessment Questions

Plans to Improve

Ongoing Program Development

Key Metrics and Evidence Summary

Rows	Yes	No	N/A	Notes:
Emergency
Surgery (OR, Recovery)
Acute Care
Rehabilitation
Other

Rows	Current value	Target	Evidence source
Admission within 48 hours
Orthogeriatric review within 24 hours
Mobilization on day 0/1
Osteoporosis medication at discharge
Delirium screening completion