Using a Triggered Endocrinology Service Consultation to Improve the Evaluation, Management, and Follow-Up of Osteoporosis in Hip-Fracture Patients

摘要: Article-at-a-Glance Background Nearly 2million osteoporosis-related fractures occur yearly in the United States, with more than 400,000 requiring hospital admissions. Fewer 30% receive proper evaluation and care for osteoporosis, representing a large opportunity to enhance secondary prevention of fractures. Methods improve identification triage hospitalized fragility-fracture patients are desirable. A multidisciplinary team was created, definitions were established an evidence-based best-practice protocol assess, treat, document osteoporosis diagnosis hip-fragility on basis recommendations from The Joint Commission National Osteoporosis Foundation. initiated preauthorized consultation endocrinology service hip-fracture patients, "triggered" via brief query admission orders or by orthopedic nurse practitioner. consultations used template reflecting protocol. Results Data analyzed 71 baseline 61 intervention patients. groups possessed similar age, gender, race, body mass index characteristics. (on-demand consultation) group suffered poor performance, only 3%–21% receiving desired evaluation, documentation, treatment, outpatient follow-up. Intervention (triggered-consultation) improved markedly postintervention, With performance increasing 52%–76% all parameters except follow-up, which changed insignificantly (6%–15%). Conclusion Although triggered effective, multimodal layered interventions may achieve even better results address several identified barriers.