St. Michael's Hospital

Foundation

A Lucky Break Leads to Breakthrough Models of Care

By taking their knowledge to the patients who have the power to prevent their own future fractures, Dr. Earl Bogach and Dorcas Beaton's team gives a new meaning to the term "teaching hospital." The sharing of knowledge assures that people at risk can take control of their health and avoid life-threatening and unlucky breaks.

An apparently healthy middle-aged woman slips on the ice and breaks her wrist. Is it an unlucky fall or is it her lucky break in preventing future, more devastating fractures? For the researchers at St. Michael's Hospital Mobility Program, this unfortunate incident of a wrist fracture, also known as a "lucky break," is a telltale sign that osteoporosis has catastrophically weakened her bones and the likelihood that a future fracture of hip, shoulder or vertebra is present, unless she receives proper treatment for the underlying disease.

Dr. Bogoch‘s research discovered that the most basic preventive osteoporosis care is missing in people who have sustained a fragility fracture.

Applying educational tools and models

Instead of simply treating the fracture, Dr. Bogoch and Beaton's team at St. Michael's Hospital has developed educational tools and models of care to help physicians and patients learn new behaviours to combat osteoporosis including proven treatments and lifestyle changes. "Healthy bones don't break that easily," says Beaton, PhD, director of Clinical Research at the Mobility Program Clinical Research Unit. "A fall from standing height that results in a wrist fracture is not normal for a person in their 40s and 50s. A fragility fracture like a wrist fracture [suggests] osteoporosis, for which there are very effective treatments and that patient needs to know about it."

A new model of care

With a patient-centric focus, Dr. Bogoch and Beaton developed a new model of care that uses an onsite co-coordinator who screens all orthopaedic inpatients and outpatients for fragility fractures and ensures they receive the proper education, bone mineral density tests and coordinates with the surgeon and physicians for treatment. This model proved so successful, with a 95 percent success rate, the Ministry of Health and Long-Care has implemented it in 24 fracture clinics province wide. This means that patients are now aware of their risks for future fractures, but can proactively take measures to avoid them.

This important work is partially funded by the Li Ka Shing Knowledge Institute. Contributing to the "Advancing care. Every day." campaign will ensure patients at St. Michael's Hospital and beyond will be able to take preventive measures against serious, life-threatening fractures.