3813 Building better bones, a quality improvement project to enhance bone health in the older person’s unit

Abstract Introduction Fragility fractures can have a profound impact on older adults’ quality of life. Optimising bone health by checking vitamin D level, FRAX score, and actioning outcomes provides a cost-effective strategy for reducing the incidence of these fractures. Our aim therefore is to promote awareness and undertaking of bone health assessments in the Older Persons Unit (OPU). Methods This was a pre-post cross-sectional study. Data was collected from 212 patient records over two separate days, one month apart. Patients admitted to the OPU at St Thomas’ Hospital were included and data was obtained from patient records using EPIC. Three strategies were implemented to improve awareness, accessibility, and time efficiency: Posters with QR codes linking relevant resources and the FRAX tool were placed throughout the OPU. An email campaign targeted both junior and senior staff to raise awareness. A shared Epic ‘SmartPhrase’ which auto-populated relevant results and provided an easy-to-follow template for documenting FRAX scores and outcomes. Results In the first data collection, FRAX documentation was recorded for 13 out of 106 patients, compared to 22 out of 106 in the second cycle (p = 0.096). Notably, vitamin D assessment and management showed significant improvement: 80 patients had their vitamin D level checked in the second cycle compared to 63 in the first (p = 0.013). Treatment of vitamin D insufficiency (<25 nmol/L) also improved from 7 of 16 patients to 12 of 14 patients (p = 0.017). Conclusion There has been a positive shift in how bone health is addressed in older patients. Most notably, vitamin D testing and treatment significantly improved. While FRAX documentation showed modest gains, the increased focus on vitamin D reflects growing awareness of bone health. This is an encouraging trend, but further engagement is required to consolidate and sustain these improvements.