Impact Snapshot

BOOSTing Recovery After Hip Fracture with Alternative Workforce Models

Project Location(s): Western Sydney Local Health District (WSLHD), Northern Sydney Local Health District (NSLHD)
Project Lead(s): Dr Marie March (WSLHD), Emeritus A/Professor Alison Harmer (University of Sydney)

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The BOOST project evaluated whether a standardised high-frequency exercise program delivered by non-physiotherapists could provide a safe, feasible, and effective method of providing routine care to hip fracture patients.

The Challenge

Strong trial evidence demonstrated that more frequent physiotherapy after hip fracture improves mobility and shortens hospital stays. However, workforce shortages among physiotherapists—combined with increasing patient volumes and greater clinical complexity—made it challenging to deliver the program at scale.

The Approach

Conducted over two hospitals (Blacktown Mt Druitt Hospital and Hornsby Ku-ring-gai Hospital) in 2021, this project involved training allied health assistants and student practitioners to deliver thrice-daily exercise sessions for post-operative hip fracture patients.

Sydney Health Partners Support

Impact as of 2026

  • The program reduced acute hospital length stays by three days, saving approximately 200 days and $130,000 per year in each participating hospital.
  • The team is collaborating with the NSW Agency for Clinical Innovation and the Australia New Zealand Hip Fracture Registry to optimise and expand hip fracture care models.
  • The project has since spurred an externally funded project titled ‘Boost 2.0’ involving the use of nursing students to deliver exercise therapy. 

Recognition

The program won the ‘Patient-Centered Care’ category at the Blacktown Mt Druitt Hospital Quality Awards in 2022.

Key Publication

March, M.K., Dennis, S.M., Caruana, S. et al. Boosting inpatient exercise after hip fracture using an alternative workforce: a mixed methods implementation evaluation. BMC Geriatr 24, 149 (2024). https://doi.org/10.1186/s12877-024-04730-x

Program

Implementation Science Academy

Partners

Northern Sydney Local Health District (NSLHD), University of Sydney, Western Sydney Local Health District (WSLHD)
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