Adoption of Hip Fracture Care Standards: A Mixed‐Methods Analysis of Patient and Healthcare Provider Perspectives

Objectives To evaluate the implementation of the Australian Hip Fracture Clinical Care Standard for patients with low‐trauma hip fracture. This study aimed to (1) document facility‐level adoption, (2) explore healthcare providers' perspectives on Standard delivery and (3) describe patient engagement with post‐acute discharge care recommendations, including outcomes for culturally and linguistically diverse (CALD) and limited English proficiency subgroups. Methods A mixed‐methods approach was undertaken. Community‐dwelling adults who underwent surgical treatment for low‐trauma hip fractures at a tertiary hospital over 1 year were included. Facility‐level adoption was determined by auditing medical records against the Clinical Care Standard. Patient engagement with post‐discharge recommendations was assessed by structured telephone follow‐up at 16 weeks and English proficiency. An electronic survey explored healthcare providers' perspectives of Standard implementation. Results Of 189 patients admitted, 136 (72%) were eligible; 127 completed follow‐up assessment. The cohort was predominantly female (66%), with a mean age of 79 years and 80% migrants. Most components of the Care Standard were implemented with high fidelity (> 90% for four of seven indicators). Acute care data indicated effective implementation of most components of the Care Standard, supported by responses from 28 healthcare providers (28% response rate). However, healthcare providers highlighted the need for enhanced interprofessional training and resourcing for refracture prevention. Patient engagement with refracture prevention recommendations was low (44% participated in strength exercises, 26% in balance, 11% sought dietary advice and 44% consumed calcium supplementation), with no significant differences by CALD status or English proficiency. Conclusions Despite high facility‐level implementation of the Care Standard, patient adoption of post‐discharge refracture prevention strategies remains suboptimal. Bridging this gap requires multi‐faceted, consumer‐centred solutions and improved interdisciplinary training to enhance outcomes and reduce refracture risk, particularly in diverse and multicultural populations.