All kind of post traumatic fractures are taken care with multidisclipinary approch liasioning with emergengency casulty doctors and other superspecilaity doctors.
Delivery of evidence-based secondary preventive care to patients presenting with fragility fractures provides an opportunity to break the fragility fracture cycle.
Osteoporotic refracture prevention services will include the key elements outlined below. The elements will be delivered by the osteoporotic refracture prevention team with responsibilities allocated as appropriate. Team members include the fracture liaison coordinator, medical officer, local falls prevention team members, and other collaborators.
People aged 50 years or more presenting with minimal trauma fractures at acute, outpatient, community and primary healthcare settings will be actively identified.
Fracture liaison coordinators will work with people, their families and carers to facilitate the appropriate delivery of care that supports reduced risk of refracture and effective management of bone health.
Comprehensive person-centred assessment
Assessment will determine future fracture risk including bone health (i.e. osteoporosis) and falls risk. It will be holistic and person-centred, taking into consideration the medical health, physical functioning, comorbidity, psychological and social needs of the person.
Patient-reported outcome measures (PROMs)
Valuable information about the person’s health and wellbeing will be gathered with the use of patient-reported outcome measures as part of the assessment process. PROMs will be used to improve quality of care by informing care planning and management.
Supported access to investigation
Access to further investigation will be supported. That may include bone mineral density scanning for either a definitive diagnosis (though not necessarily required to start treatment), to monitor treatment over time, or to assess for future fracture risk. Serum blood assays may also be indicated to look for underlying causal disease processes.
Initiation of appropriate medical interventions
Required medical treatment will be initiated .This treatment will include the prescription of an osteoporosis medication regimen as an addition to conservative care measures, such as vitamin D and calcium supplementation.
Health education and self-management support
Health education and self-management support will be provided to enhance knowledge and support active and informed engagement in care. It will promote a healthy lifestyle, physical activity, good nutrition and healthy eating, and osteoporosis treatments that support bone health and reduce fracture risks.
Development of a personalised management plan
A personalised management plan will be established to promote planning and application of long-term chronic disease management. It will be designed to help the person address their care needs and to meet their health goals within the context of their care preferences.
People will be linked to the appropriate multidisciplinary support to promote bone health and reduce falls and fracture risks. This will be achieved through establishing and fostering relationships and referral pathways to services.
Access to community services
Local community resources will be used to provide ongoing self-management support for people to facilitate behaviour change (e.g. falls prevention).
Timely and efficient communicationCommunication between primary and secondary care physicians, allied health and community service providers will facilitate reinforcement and continuity of care across healthcare settings and ensure optimum adherence with treatment and recommendations.
Follow-up will support the maintenance of long-term lifestyle and behaviour changes and adherence with treatment and interventions.
Services will have data systems to collect and record the person’s interventions; collate patient outcomes; and analyse and report on service outcomes.
Patient-reported experience measures (PREMs)
Patient-reported experience measures will be used to support service evaluation and inform improvements.
Engagement in quality improvement
Regular time will be assigned in the service weekly plan to critique service interventions and processes, follow up on patient care, conduct literature reviews seeking solutions to identified issues, and plan and implement quality improvement cycles as required.
Trauma coordinator to liaison among general physician/specialist/orthopedic surgeon/endocrinologist for a centralized reporting for any primary fragility fracture/documented osteoporosis for fracture prevention and fall risk assessment.
Auditing and implementing of the above guidelines.