Early Rehabilitation for Patients with Hip Fractures: Spreading Change Across the System.

Evidence suggests that patients with hip fractures should begin rehabilitation no later than six days following surgery. The reality is often far different. In an initiative led by the Greater Toronto Area (GTA) Rehab Network, acute care and rehab/complex continuing care hospitals across the GTA have implemented a new early referral process to aid transition of patients from acute care to inpatient rehabilitation as early as possible to improve their outcomes. Two of the participating acute care hospitals have now surpassed the six-day target and two others are within range. The initiative also provides useful learnings to guide other cross-sector change and spread initiatives.

Factors associated with self-reported arthritis 7 to 24 years after a traumatic brain injury.

The purpose of this study was to profile characteristics of people with traumatic brain injury (TBI) who self-reported arthritis 7 to 24 yr. post-injury. Pre- and post-injury socio-demographic factors, injury-related factors, and postinjury standardized assessments measuring health, activity, and participation outcomes were assessed in a retrospective cohort study of 274 participants. The group self-reporting arthritis had significantly more sleep disturbances, poorer overall health, lower mental health and physical function, and decreased productivity. Also, they were older and reported a shorter length of loss of consciousness from TBI. These resulted suggest that musculoskeletal complaints from long-term survivors of TBI sholud be addressed in post-acute care and could guide future research on arthritis in the TBI population.