Abstract
Introduction: The Frailty Same Day Emergency Care (SDEC) unit at Fairfield General Hospital provides same day Comprehensive Geriatric Assessments (CGA). Bone health is an integral part of CGA, however recognition and management of osteoporosis is often not prioritised in acute hospital settings. We noticed that bone health was an area that was often overlooked within our CGAs. Our goal was to increase the number of bone health assessments performed and improve access to appropriate treatment for patients in the Frailty SDEC. The aim of this project was to increase the number of appropriately managed FRAX scores by 40% within 12 weeks in high-risk patients.
Method: Baseline data was collected on all patients attending Frailty SDEC 2 days per week over an 8 week period. We measured how many patients were having FRAX scores calculated. Analysis of the baseline data indicated that patients presenting with falls were not having FRAX scores completed. Our change idea was implementing a bone health pathway which was displayed on the Frailty SDEC unit. This helped guide and remind clinicians when to calculate a FRAX score.
Results: Bone health assessment in patients presenting with falls to Frailty SDEC was improved from 40% pre-intervention, to 80% post-intervention. Of those who were identified as needing treatment for osteoporosis, all patients had an appropriately assessed treatment plan and none were untreated who had been deemed appropriate for treatment.
Conclusion: The implementation of a bone protection pathway has led to an improvement in the amount of FRAX scores calculated for patients attending with a fall. Our pathway was implemented across the Northern Care Alliance as part of a Quick Reference Guide for Frail Fallers Attending Frailty SDEC.