Understanding governance for a national hip fracture clinical audit: a scoping review

There is a plethora of literature regarding hip fracture care, including care standards, use of registry/clinical audit data for improvement, benchmarking and outcomes. There is, however, very little published information describing how to establish and govern a national hip fracture audit. To explore the availability of information about hip fracture national clinical audit (NCA) development and governance, a scoping review was conducted.

Electronic searches of MEDLINE (Ovid), Embase (Elsevier) and CINAHL (EBSCOHost) were conducted for articles describing national hip fracture clinical audits, published in English between 1988 and 2024. Factors for establishing the governance of a national hip fracture clinical audit were extracted and reported. Findings were shared with knowledge users from the Global Fragility Fracture Network (FFN) Hip Fracture Audit Special Interest Group and the Irish Hip Fracture Database Governance Committee to ascertain their completeness and validity. Descriptive analysis was used to summarise findings.

Thirteen articles were eligible for inclusion, representing 60 % of the known established hip fracture NCAs. From these, 11 components for the governance of hip fracture NCAs were identified, however the level of detail varied across the included articles. At least one of these components appeared in 83 % of the included articles, suggesting substantial consistency across hip fracture NCAs. Notably, five articles provided descriptions of all 11 components.

Overall, there was congruency in the approach taken to establish the governance of hip fracture NCAs and therefore the components identified could be used to support existing and emerging hip fracture NCAs in their development and sustainability.