Use of an integrated care pathway in improving secondary prevention of osteoporosis

The authors audited how many patients admitted with hip fractures were correctly commenced with treatment for the secondary prevention of osteoporosis by the time of discharge. Such treatments were recognized as the standard of care by current guidelines. The initial audit cycle consisted of a retrospective review of 20 case notes of patients admitted with hip fractures, aged 65 years. This initial cycle identified that correct osteoporosis medications were started in only 40% of patients at discharge. Following this, an integrated care pathway (ICP) combining different elements of care for patients admitted with hip fractures was introduced. This ICP included tick-boxes for expected actions, including prescription for medications for secondary treatment of osteoporosis. A second cycle of audit was performed after the introduction of this ICP for 20 sets of case notes. This cycle found that prescription of medications for the secondary prevention of osteoporosis had increased to 80% by the time of discharge. The authors concluded that the tick-box approach had acted as ‘an aide-memoir’ to improve the quality of patient care.