Rehab at Home: The Hutt Valley Model for Hip Fracture Recovery

Send a textIn this episode of Hipcast, we’re joined by the Waitematā Hip Fracture Team in Aotearoa New Zealand, winners of the ANZHFR Golden Hip Award for five consecutive years.Dr Min Yee Seow (Clinical Lead, Orthogeriatric Service), Vandhana Sharan (Orthopaedic Charge Nurse), and Kyleigh Pailman (Orthopaedic Physiotherapist) share how their multidisciplinary team has built one of the highest-performing hip fracture services across Australia and New Zealand.The conversation explores the practical systems, team culture, and small operational changes that help Waitematā consistently deliver high-quality care – from coordinated multidisciplinary teamwork and early mobilisation to managing common challenges such as delirium and patient flow.Importantly, the team reflects on the lessons learned along the way and offers practical advice for services looking to improve their own hip fracture care.Whether you work in orthopaedics, geriatrics, nursing, physiotherapy, or health service leadership, this episode provides valuable insights into how strong teamwork and continuous improvement can translate into better outcomes for patients with hip fracture.🎙️ Hipcast is hosted by Dr Niamh Dove and produced by the Australian and New Zealand Hip Fracture Registry, dedicated to improving outcomes and experiences for people with hip fracture and those who care for them.

Send a textIn this episode of Hipcast, we’re joined by Lauren Wulff, a community physiotherapist with the AWHI Early Supported Discharge Team in the Hutt Valley, New Zealand. With limited access to inpatient rehabilitation beds, Lauren and her team have built a comprehensive, high-functioning community-based rehabilitation model that supports patients from the moment they leave hospital.Lauren shares how the Hutt Valley service delivers safe early discharge, provides intensive home-based rehabilitation, and equips patients and whānau with the skills, confidence, and support they need to regain mobility and independence.Whether you work in orthopaedics, geriatrics, allied health, general practice, or community care, this episode provides actionable insights into delivering high-quality rehabilitation outside the traditional ward environment.🎙️ Hipcast is hosted by Dr Niamh Dove and produced by the Australian and New Zealand Hip Fracture Registry, dedicated to improving outcomes and experiences for people with hip fracture and those who care for them.

Send a textIn this episode of Hipcast, we explore the newly released Clinical Standards for Secondary Fracture Prevention Programs, developed by the SOS Fracture Alliance (SOSFA) and released in November 2025.Joining us are:Professor Markus Seibel, Chair of the SOS Fracture Alliance and Professor of Medicine at The University of SydneyDr Lauren Nacey, Geriatrician and leader in secondary fracture preventionProfessor Rudi Jaarsma, Academic and Clinical Director of Orthopaedic Surgery at Flinders Medical CentreDr Fiona Mackie, consumer representative with lived experience of osteoporosis and fracture riskTogether, they discuss why these standards were developed, the evidence and expertise that informed them, and how they aim to improve care for people who sustain a fragility fracture.🎙️ Hipcast is hosted by Dr Niamh Dove and produced by the Australian and New Zealand Hip Fracture Registry, dedicated to improving outcomes and experiences for people with hip fracture and those who care for them.

Send a textDr Grace Taylor from the Department of Orthopaedic Surgery, North Shore Hospital, Auckland, New Zealand joins to share findings from her research "Standard of care and outcomes for Māori patients with neck of femur fractures" published in the ANZ Journal of Surgery. 

Send a textIn this episode of Hipcast, we speak with three clinical experts about the complexities of surgical timing in hip fracture patients who are taking SGLT2 inhibitors and GLP-1 receptor agonists.Professor Jacqueline Close (Consultant Geriatrician, Prince of Wales Hospital / Neuroscience Research Australia), A/Prof Katherine Tonks (Endocrinologist, Sydney Endocrinology / St Vincent’s Hospital) and Dr Louisa Lowes (Anaesthetist and Director of Perioperative Medicine, Prince of Wales Hospital) share insights from their respective disciplines on balancing surgical urgency with medication-related risks.The discussion explores:Mechanisms and perioperative considerations of SGLT2 inhibitors and GLP-1 agonistsHow these agents influence timing and safety of hip fracture surgeryInterdisciplinary strategies to minimise perioperative complicationsPractical take-aways for clinicians🔗 Resources mentioned:Australian Diabetes Society (ADS):Peri-operative Management of Diabetes MedicationsANZCA Safety Alert: ALERT UPDATE May 2023 Periprocedural Diabetic Ketoacidosis (DKA) with SGLT2 Inhibitor Use In People with DiabetesANZCA Safety Alert: Clinical Practice Recommendations regarding patients taking GLP-1 receptor agonists and dual GLP-1/GIP receptor co-agonists prior to anaesthesia or sedation for surgical and endoscopic procedures.Australian and New Zealand Hip Fracture Registry (ANZHFR):Clinical Care Standards and Annual ReportA/Prof Katherine Tonks resource: Is your patient on a SGLT-2 Inhibitor?ANZCA Patient Instructions: Preparing for your medical procedure when taking some diabetes and/or weight loss medications🎙️ Hipcast is hosted by Dr Niamh Dove and produced by the Australian and New Zealand Hip Fracture Registry, dedicated to improving outcomes and experiences for people with hip fracture and those who care for them.

Send a textIn this special episode of Hipcast, host Dr Niamh Dove speaks with Nick May, husband and carer of his wife Fleur who sustained a hip fracture and underwent hospital treatment and recovery.Nick shares his reflections on navigating the hospital experience, the realities of recovery at home, and how life changes after a hip fracture - from the viewpoint of the person providing day-to-day care. His story highlights the essential role of carers in supporting recovery and what health professionals can learn from their perspective.This episode is brought to you by the Australian and New Zealand Hip Fracture Registry (ANZHFR), dedicated to improving outcomes and experiences for people with hip fracture and their families.

Send a textOn this episode, A/Prof Jennifer Stevens and Emma Pauley share findings from their quality improvement project titled: A post-operative analgesic bundle of fascia iliaca catheter and celecoxib for elderly patients with hip fracture: a quality improvement project. Jenny is an Associate Professor at both University of Notre Dame and UNSW as well as an anaesthetist and pain specialist at St Vincent’s Campus in Sydney, Australia. Emma is a Senior Orthopaedic Physiotherapist, also at St Vincent’s Hospital Darlinghurst. Please find below the links for the resources mentioned in this episode:ANZCA Resources for Change: https://www.anzca.edu.au/getContentAsset/4e02b985-9852-426f-aa16-b7f06ac2725a/80feb437-d24d-46b8-a858-4a2a28b9b970/Celecoxib-guidelines-May-2024.pdf?language=enGawthorne J, Stevens J, Faux  S, Leung J, McInnes E, Fasugba O, Mcelduff B, Middleton S. Can emergency nurses safely and effectively insert fascia iliaca blocks in patients with a fractured neck of femur? A prospective cohort study in an Australian emergency department. Journal of Clinical Nursing. 9th June 2021. https://doi.org/10.1111/jocn.15883Riley M, Tassie B, Gawthorne J, Hadzic R, Stevens J. Increased opioid consumption following regional nerve blockade: could fascia iliaca block be associated with rebound pain in neck of femur fracture? Br J Anaes. 10 May 2021. https://doi.org/10.1016/j.bja.2021.03.034 

Send a textOn the episode, the Older Persons Emergency Network (OPEN) Clinical Director Dr Elizabeth (EJ) Marsden and OPEN nurse practitioner Sarah Bold share their teams achievements to provide pre-hospital hip fracture care. The OPEN Metro North  team provides a pre-hospital neck of femur fracture pathway as a Queensland Ambulance Service co-response emergency department substitution model to provide timely outreach care for frail older persons living in residential aged care facilities and the community.

Send a textJoining us on this episode to revisit and update on the topic of direct oral anticoagulants, or DOACS, and timing of surgery are Dr Hannah Seymour, a consultant geriatrician from Fiona Stanley Hospital in WA and Dr Seth Tarrant an orthopaedic surgeon from John Hunter Hospital NSW. We covered this topic on this Hipcast episode in 2024 with Hannah and Professor Rebecca Mitchell following the results of ANZHFR Sprint Audit and publication of the Fragility Fracture Networks’ consensus statement in the journal Anaesthesia.  We will also be looking at how time to surgery is tracking across AU and NZ and implications of this for practice.

Send a textDr Suzanne Dyer presents on What the Evidence Tells Us in Rehabilitation at the ANZHFR Hipfest 2023. Dr Dyer is a senior research fellow at Flinders University, she’s worked as a researcher in both the public and private sector with expertise in evidence based methodologies including health technology assessment, systematic reviews, meta-analysis and guideline development. She’s the author of over 70 publications and reports including the Cochrane Review on Interventions for Improving Mobility after Hip Fracture.Please find the mentioned research below:- Interventions for improving mobility after hip fracture surgery in adults - 2022 Cochrane Review- Multidisciplinary rehabilitation for older people with hip fractures - 2021 Cochrane Review- Enhanced rehabilitation and care models for adults with dementia following hip fracture surgery - 2015 Cochrane Review