Section 1: demographics

1. What is the name of the hip fracture centre where patients you treat have their hip fracture surgery (e.g. name of acute hospital)?
2. What is your role in hip fracture rehabilitation?
3. What Agenda for Change band are you?
   • –  5.
   • –  6.
   • –  7.
   • –  8a.
   • –  8b.
   • –  Other, please specify.
4. Where do you work? (Ask them to decide whether they are an inpatient or outpatient/community-based occupational therapist and choose which set of questions to answer.)
   • –  Acute hospital: route to inpatient occupational therapist questions.
   • –  Community hospital: route to community-run hospital/rehabilitation unit occupational therapist questions.
   • –  Community care: route to community occupational therapist questions.
   • –  Other, please specify.

Section 2: inpatient occupational therapist questions (routed from Q4a)

1.

What sort of ward do the hip fracture patients you treat usually go to after surgery for their rehabilitation? Tick all that apply.

• –  Orthopaedic trauma ward.
• –  GORU – geriatric orthopaedic rehabilitation unit.
• –  MARU – mixed assessment and rehabilitation unit.
• –  Outliers/sleepers on any type of ward.
• –  Other.
• –  If ticked more than one please, write provide approximate proportions of patients going to each type of unit.

2.

Do you follow a multidisciplinary team integrated care pathway for hip fracture patients? If yes, please attach a copy of the pathway when you return this questionnaire.

3.

Are patients with hip fracture routinely seen by an occupational therapist (or an occupational therapy assistant) pre-operatively?

4.

When are patients with hip fracture usually seen by an occupational therapist (or an occupational therapy assistant)?

• –  Post-operative day 0.
• –  Post-operative day 1.
• –  Post-operative day 2.
• –  Post-operative day 3.
• –  Post-operative day 4.
• –  Post-operative day 5.
• –  Other.

5.

What do occupational therapists assess for? ADL, anything specific for hip fracture patients?

6.

What intervention do you give?

• –  Assessment of home for modifications and aids.
• –  ADL practice. Please specify, e.g. kitchen practice.

7.

How often do occupational therapists usually see patients following hip fracture surgery during their inpatient rehabilitation? Please write in how many times over how many days.

• 7b. How long are these sessions?

8.

Do occupational therapists routinely make a home visit for patients following hip fracture prior to discharge?

• –  Yes, for the majority of patients. If yes, is the home visit usually carried out with the patient or carer or patient and carer?
• –  Yes, for some patients. If yes, is the home visit usually carried out with the patient or carer or patient and carer? Please also describe which patients receive a home visit and how this is decided.
• –  No routine home visits are carried out. If ticked, is any assessment of the home made? Please describe.

9.

Do your proximal hip fracture patients have a routine assessment of any of the following? Please tick all that apply.

• –  Cognitive status.
• –  Mood.
• –  Self-efficacy.
• –  Fear of falling.

• 9b. For each answer ticked above, which professional makes this assessment and which tool, if any, do they use (e.g. Mini Mental State Examination)?

10.

Are patients routinely referred to or signposted to social support or activities when discharged? If yes, what sort of activities and who provides them (e.g. Age Concern, local charity running a voluntary befriending service)?

11.

Please describe anything else that occupational therapists routinely do as part of rehabilitation for patients after hip fracture surgery.

Section 3: community-run hospital/rehabilitation unit occupational therapist questions (routed from Q4b)

1. On which post-operative day are patients usually transferred to your hospital/unit?
   • –  Mostly within the first week post-operatively.
   • –  Mostly in the second week post-operatively.
   • –  Mostly in the third week post-operatively.
   • –  Other, please specify.
2. What assessments do occupational therapists use as part of routine rehabilitation for patients aged > 65 years who have had surgery for proximal hip fracture at your centre?
   • –  An individual assessment of functional tasks? Does this include any of the following?
     • –  Transfers.
     • –  Personal ADL.
     • –  Domestic ADL.
     • –  Environment.
     • –  Social support.
     • –  Other, please specify.
   • –  An individual assessment of posture and seating?
   • –  A routine assessment of any of the following?
     • –  Cognitive status.
     • –  Mood.
     • –  Self-efficacy.
     • –  Fear of falling.
     • –  None of the above.
3. For cognitive status, mood, self-efficacy, fear of falling: who (which profession) makes this assessment, when and which, tool do they use if any (e.g. mini mental state)?
4. What does occupational therapist rehabilitation routinely consist of at your centre? Please tick all that apply.
   • –  Practising various ADL.
   • –  Other activities to encourage independence.
   • –  Education about hip precautions.
   • –  Anxiety management.
   • –  Developing self-awareness.
   • –  Falls prevention techniques.
   • –  Providing information about falls prevention services.
   • –  Referral to falls prevention services.
   • –  Referral to social services.
   • –  Referral to the discharge team.
   • –  Prescribing specific equipment (e.g. raised toilet seat, banister rails).
   • –  Other, please describe.
5. How frequently do occupational therapists usually see patients following hip fracture surgery during their community rehabilitation?
   • –  Every day.
   • –  Every other day.
   • –  Every third day.
   • –  Twice a week.
   • –  Once a week.
   • –  Once a fortnight.
   • –  Other, please specify.
6. How long are these sessions?
7. Do occupational therapists make a home visit for patients following hip fracture prior to discharge?
   • –  Yes, always.
   • –  Yes, for some patients according to need.
   • –  No.
8. Are patients routinely referred to or signposted to social support or activities when discharged? If yes:
   • –  What sort of activities and who provides them (e.g. Age Concern, local charity running a voluntary befriending service)? Please describe.
9. Please describe anything else occupational therapists routinely do as part of rehabilitation for patients after hip fracture surgery.
10. Please describe what you think are the good aspects of your service.
11. Please describe anything about your service that could be improved and how.

Section 4: community occupational therapist questions (routed from Q4c)

1.

How would you best describe the community rehabilitation service that you are part of? Please tick one option.

• –  Early supported discharge service in which patients are discharged home and receive a package of rehabilitation care for a short period (e.g. 4–6 weeks).
• –  Intermediate care in which patients are transferred form the acute hospital to a community rehabilitation unit or nursing home where they receive their rehabilitation before being discharged home or to long-term care.
• –  Community occupational therapy team that is not part of the early supported discharge or intermediate care team.
• –  Other please describe.

2.

Do community occupational therapists routinely make a home visit for patients who have had hip fracture surgery prior to discharge?

• –  Yes, for the majority of patients. If yes, is the home visit usually carried out with the patient or carer or patient and carer?
• –  Yes, for some patients. If yes, is the home visit usually carried out with the patient or carer or patient and carer? Please also describe which patients receive a home visit and how this is decided.
• –  No routine home visits are carried out. If no, is any assessment of the home made? Please describe.

3.

Do occupational therapists from the community team attend multidisciplinary team discharge meetings at the acute hip fracture centre that most of your patients are treated in?

• –  Yes, routinely.
• –  Yes, for some patients.
• –  No.

Comments:

4.

How soon after discharge do community occupational therapists usually see patients who have had hip fracture surgery?

• –  Day of discharge.
• –  1 day after discharge.
• –  2 days after discharge.
• –  Other, please specify.

5.

What do you assess for? ADL, anything specific for hip fracture patients?

6.

What intervention do you give?

• –  Assessment of home for modifications and aids.
• –  ADL practice. Please specify, e.g. kitchen practice.

7.

How often do occupational therapists usually see patients following hip fracture surgery during their community rehabilitation? Please write in how many times over how many days.

• 7b. How long are these sessions?

8.

Do your proximal hip fracture patients have a routine assessment of any of the following? Please tick all that apply.

• –  Cognitive status.
• –  Mood.
• –  Self efficacy.
• –  Fear of falling.

• 8b. For each answer ticked above, which professional makes this assessment and which tool, if any, do they use (e.g. Mini Mental State Examination)?

9.

Are patients routinely referred to or signposted to social support or activities when discharged? If yes, what sort of activities and who provides them (e.g. Age Concern, local charity running a voluntary befriending service)?

10.

Please describe anything else that occupational therapists routinely do as part of rehabilitation for patients after hip fracture surgery.