What is Fracture Liaison Service?
Low-trauma (sometimes referred to as fragility fractures) occur spontaneously or following minor trauma such as coughing, sneezing or falling from standing height. Individuals who sustain such a fracture are at a much higher risk of sustaining a second or third fracture, leading to progressive disability, chronic pain and decreased quality of life. Despite the availability of effective treatments that can reduce future fracture risk by up to 50%, less than 20% of patients suffering low-trauma fractures receive such treatments in their post-fracture care. This is the post-fracture osteoporosis care gap.
Systematic reviews of different clinical models of care designed to close the osteoporosis care gap have found that the Fracture Liaison Service (FLS) model was the most effective at improving patient care outcomes after an osteoporosis related fracture. Integral to an FLS program is a dedicated coordinator who pro-actively identifies fracture patients, determines their risk of having repeat fractures and facilitates effective osteoporosis treatment for high-risk patients. FLS programs “capture” the patients at the point of orthopedic care, and seamlessly integrate secondary fracture prevention into the acute fracture experience. The coordinator also links with primary care providers to maintain communication during patient assessment and upon discharge from the FLS to ensure sustainability and follow-through of initiated interventions. FLS will improve osteoporosis care for fracture patients in addition to reducing overall healthcare costs by preventing expensive repeat fractures.
The 3 i's
Osteoporosis Canada’s (OC) defines FLS as: ‘a specific systems-based model of care for secondary fracture prevention where a dedicated FLS coordinator’:
Osteoporosis Canada Resources
FLS in BC
Peace Arch Hospital FLS articles
FLS is currently under development in Richmond, with support of the health authority. The team there is planning for operation of the FLS to begin in 2022.
Ideas for funding
Looking to get the discussion started about FLS implemented in your region? Consider applying for funding for collaboration. Here are some options in BC.
Facility Engagement was launched by the Specialist Services Committee in 2016 as a BC-wide initiative to strengthen communication, relationships and collaboration between facility-based physicians and their health authorities. The goal is to increase meaningful physician involvement in health authority decisions about their work environment and the delivery of patient care.
Formed in 2006 as part of the Physician Master Agreement, the Shared Care Committee is one of four Joint Collaborative Committees (JCCs) representing a partnership of the government of BC and Doctors of BC.
Health System Redesign
An initiative under the Specialist Services Committee. The purpose is to compensate physicians at the sessional rate for participation in time-limited, project-based, system redesign work within a health authority or community with health authority involvement.
Your Hospital Foundation
Most hospitals have a foundation supported by donors. The foundations may provide short-term funding for initiatives focused on transforming and bettering health care. Consider reaching out to your local hospital foundation for a discussion.