Preventing osteoporosis-related fractures from happening (again)

SummaryOsteoporosis is an increasingly common chronic disease. Despite several high quality evidence-based guidelines, osteoporosis remains largely under-diagnosed and under-treated in many Australian health settings. The implementation of a clinical pathway to better identify and manage patients at risk of osteoporosis in a large metropolitan hospital is described.The pathway consisted of identifying patients with low trauma fractures, assessing risk and implementing early treatment. The implementation process involved change champions, stakeholder focus groups and improving communication between healthcare providers. Three-monthly audits assessed change in practice and outcome which may be attributed to the clinical pathway.Steady and sustained improvements in processes and outcomes were recorded. More at-risk patients were identified earlier and management plans were increasingly aligned with best-practice. Stronger links were forged between hospital and GP care.Multi-faceted, repetitious strategies were required to sustain the clinical pathway. Stakeholders had different requirements, needing different approaches to ensure uptake of best-practice care.