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      Osteoporosis Best Practices Learning Collaborative

      Osteoporosis Collaborative Outcomes: Quality Improvement Process

      Osteoporosis Collaborative Outcomes: Data Highlights and Insights

      Background

      Within AMGA Foundation’s Osteoporosis Best Practices Learning Collaborative, the following eight motivating needs were identified as barriers to providing quality patient care.

      Each participating healthcare organization selected a few motivating needs from the list to focus on for improvement in their organization. Below are some interventions developed by the participating organizations.

      Motivating Need 1:

      Identifying individuals in a population who are at risk for fracture
      Additional DXA machines for better access and increase scheduling availability
      Initial DXA screening Best Practice Alert to fire once or every 7 years by default if not acted upon
      Integrated DXA screening into the annual wellness visits

      Developed an osteoporosis-related fracture screening algorithm and disseminate it to PCPs, gynecology, and endocrine departments with provider education at departmental meetings

      Achieve additional referrals to the osteoporosis clinic for appropriate patients as determined by inpatient clinical criteria

      Built “Standing Orders” for staff to order referrals to the post-fracture clinic or to directly order a DXA

      Motivating Need 2:

      Testing and clinical assessment of patients at risk for fracture according to current clinical practice guidelines
      Update DXA report format to facilitate accurate diagnosis and interpretation of results.

      Motivating Need 3:

      Diagnosis and documentation of patients at risk for fracture with appropriate use of testing, fracture risk scores, and clinical assessment

      Weekly review of all DXA and X-rays for an abnormal bone DXA (T score < -1.0) or presence of fragility fractures. Developed a new osteoporosis process for abnormal bone DXA

      • Implement procedures for documentation of evidence of osteoporosis in patient’s medical record

      • Developed osteoporosis pathway

      Developed Best Practice Alerts that will re-display every time a patient qualifies for the screening and no DXA was done or a referral in the last 365 days

      Motivating Need 4:

      Adequate treatment of patients with osteoporosis at risk for fracture
      Partnered with EMR analyst to develop embedded treatment suggestions, data capture tools, and automated communications back to the care team to facilitate quality improvement efforts.

      Develop Smart Sets in Epic for patients diagnosed with osteoporosis including medication interventions, laboratory tests, and imaging. Developed Best Practice Alert in EPIC for screening patients post-fracture

      Motivating Need 5:

      Secondary fracture prevention

      Joseph Baglio, MBA, Senior Vice President, Eastern Region Ambulatory Services; Armando Castro-Tié, MD, Senior Vice President, Eastern Region Ambulatory Physician Executive; Cindy Maher, Associate Executive Director, Site HR Officer, Eastern Region Ambulatory Services; and 
      Jeffrey Musmacher, Assistant Vice President, Operations, Eastern Region Ambulatory Services, Northwell Health

      Hospitals and physicians have used a service line approach for decades in an effort to provide efficient, high-quality care to well-defined patient populations. During this interactive session, speakers will explore the decision to move from a service line to a regionalized model and the impact this transformation has made in areas such as access, quality, patient experience, engagement, finance, and business development. The presentation will also provide guidance for leaders on navigating structural transformations and emphasizing key programs and quality improvement initiatives, to meet the CMS ACO quality screening measures.

      Upon completion of this session, participants should be able to:

      • Lead thoughtfully through structural transformations to better serve patient and community needs

      • Build nimble and high-performing teams that embrace change and drive positive results

      • Foster collaborative and integrative relationships between medical groups and acute care facilities to provide robust, complementary services for patients within a geographic area and develop a culture of trust and engagement that prioritizes the team member, physician, and patient experience

      Dan Liljenquist, Chief Strategy Officer, Intermountain Health

      In the rapidly evolving landscape of healthcare, maintaining a strong and cohesive organizational culture is essential for achieving excellence in patient care and operational efficiency, especially in a growing organization. This session will explore strategies and best practices for sustaining your organizational culture amidst the pressures of a changing healthcare environment, drawing on the experiences and successes of Intermountain Health. Through the use of table conversations, participants will begin creating tactics and strategies to position and sustain an organization’s culture as a vital cornerstone that will drive performance, engagement, and patient satisfaction.  

      Upon completion of this activity, participants should be able to:

      • Identify the critical components of a strong organizational culture and its impact on patient care, operational efficiency, and employee engagement

      • Analyze real-world examples from Intermountain Healthcare to understand how to manage cultural continuity during periods of transformation

      • Examine the role of leadership in fostering a resilient organizational culture and maintaining clear, open communication during change

      Steven Kalkanis, MD, EVP, Henry Ford Health, CEO, Henry Ford Medical Group, and CEO, Henry Ford Hospital 

      As AI technologies continue to evolve and become integrated into clinical and administrative processes, it is crucial to adopt robust governance frameworks that ensure ethical implementation, data integrity, and compliance. In this interactive session, Dr. Kalkanis will delve into common challenges encountered in AI integration, such as data privacy, algorithmic bias, and regulatory compliance, and explore strategies to overcome these hurdles. Participants will engage in group discussions to share insights and develop actionable best practices for implementing AI governance within a healthcare organization.  

      Upon completion of this session, participants should be able to:

      • Recognize the importance of robust governance frameworks in the successful integration of AI technologies in healthcare settings

      • Utilize insights gained from the session to create a framework that ensures ethical implementation, data integrity, and regulatory compliance in AI systems

      • Explore methods for promoting a culture of responsible AI use within your organization, ensuring that all stakeholders are aligned with governance objectives

      Motivating Need 6:

      Knowledge deficit of prevention and management of patients with osteoporosis

      Changed fall risk screening tool requirements from annual to biannual to identify those patients who are at high risk for falls to include the post-fracture patient.

      Primary care WebEx on osteoporosis treatment guidelines & osteoporosis screening recommendations added to the internal website.

      Motivating Need 7:

      Patient awareness and education about osteoporosis

      Questionnaire developed and distributed to patients to assess their knowledge of osteoporosis. Patient education material developed from survey responses

      Create multi-media (brochures/EMMi video/web links), multi-channel (My Chart messages, AVS updates, patient brochures) patient education campaign

      Motivating Need 8:

      Care coordination for patients with osteoporosis and fracture

      Collaboration between Clinical pharmacist and virtual engagement provider to provide outreach to virtual high-risk patients with prior hip fractures for medication and treatment management to prevent secondary fractures.

      Standardize clinical care coordinator outreach to schedule DXA to close care gaps
      Work with the IT department to create a form within the EMR to capture DXA/FRAX scores

      Survey to understand healthcare providers’ understanding of osteoporosis and provide education.