Orthogeriatric: Acute Hip Fracture Management model of care

The Orthogeriatric: Acute Hip Fracture Management model of care (PDF 796KB) delivers consistent high-quality, patient-centred, evidence-based care to all South Australian orthogeriatric patients who are diagnosed with a hip fracture.


The model of care aims to ensure patients receive consistent, quality care from admission through to discharge. Patients will also be provided with timely and effective pain management, appropriate time to theatre and day one mobilisation by a physiotherapist. This will provide the best possible opportunity for the patient to return to their pre-fracture function and mobility.

Development of the Model

The Model was originally developed in 2016 in consultation with multi-disciplinary clinicians with representation from all Local Health Networks, with the exception of Women’s and Children’s Health Network. The model aligns with the Australian Commission on Safety and Quality in Health Care’s Hip Fracture Care Clinical Care Standard and the Australian and New Zealand Hip Fracture registry’s Guidelines for Hip Fracture Care (PDF 4.8MB).

Revision of the Model

The Model was revised in September 2023 to align with the release of the updated Hip Fracture Care Clinical Care Standard. Several changes were made to the clinical care standard which are now reflected in the revised model of care. Key changes include:

  • Surgery in 36 hours: Time to surgery reduced from 48 to 36 hours of presenting at any hospital.
  • Multidisciplinary care: Identify and manage malnutrition, frailty and delirium.
  • Pain management: Offer a ‘nerve block’ injection in the groin to provide fast pain relief.
  • Cultural safety: Better communication to ensure First Nations people receive safe and equitable care.

In addition to these changes, the updated model of care is now more inclusive, extending its coverage to patients who are either:

  • 50 years and over, or
  • under 50 years but presenting with fractures caused by osteoporosis or osteopenia.

Furthermore, the appendices within the model of care now provide suggested Sunrise EMR acronym expansions to support documentation.

Orthogeriatric Fracture Centres

The model of care has been developed and implemented in specialist Orthogeriatric Fracture Centres (OFCs) across five sites:

  • Flinders Medical Centre
  • Lyell McEwin Hospital
  • Mount Gambier and Districts Health Service
  • Royal Adelaide Hospital
  • The Queen Elizabeth Hospital.

The Orthogeriatric Fracture Centres act as centres of excellence and are equipped to provide comprehensive clinical care to deliver the best potential outcome for a patient to return to their pre-fracture function and mobility.