HIP FRACTURE CARE IN RURAL SOUTHWESTERN ONTARIO AN ETHNOGRAPHIC STUDY OF PATIENT TRANSITIONS AND PHYSIOTHERAPY HANDOFFS

Abstract

Patients with hip fracture transition through several care environments during recovery. The purpose of this study was to examine information exchange by physiotherapists during care handoffs o f patients with hip fracture. Using an ethnographic approach, 11 patients with hip fracture and their networks of family caregivers (n=8) and health care providers (n=24) were recruited in a rural community of southwestern Ontario. Patients were followed from acute care through each post-acute care setting. Data sources included semi-structured interviews, observations and document review.An inductive analytic approach was used. Findings revealed that handoffs were challenged when information transfer was untimely. Family caregivers experienced challenges in obtaining information required to facilitate the handoff. Major implications included: appropriate methods to facilitate information exchange by physiotherapists in various rural settings need to be identified; and health system practices which ensure patients and family caregivers receive adequate information at care handoffs need to be developed

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