Leading Better Value Care
Local vignette – Western Sydney LHD

Osteoporotic re-fracture prevention

Multidisciplinary clinic – a clinician's perspective

By Allison Sigmund

28 Apr 2021 Reading time approximately


What is important to know about your service?

The Osteoporotic Refracture Prevention (ORP) clinic is based at Blacktown Hospital and services around 336,000 patients in the western Sydney area.

What organisational model do you use?

A multidisciplinary model.

Identification and triage
leads to
Assessment and diagnosis
leads to
Treatment initiation
leads to
Coordination of ongoing care

What is special about the way care is delivered that is valuable for others to know?

The clinic is run with a multidisciplinary team, including a fracture liaison coordinator, endocrinologist, dietitian, occupational therapist and physiotherapist.

Patients have an onsite bone density assessment during their clinic visit and have the option to return for regular exercise classes.

The exercise classes can be accessed by anyone who has been referred to and attended the program, and has been seen by the doctor and physiotherapist.

A home-based or personalised exercise program can be provided following an individual assessment with the physiotherapist.

The different skills of the clinicians in the service combine to provide a comprehensive multidisciplinary approach.

The space is within the Western Sydney University building, which is a well-equipped spacious facility that is easily accessible to patients.

A companion document describes options for organisational models in osteoporotic refracture prevention. One option is a multidisciplinary shared care model – this vignette describes the model from a local perspective

How does it make a difference?

It is important to have a multidisciplinary team with administration support that are keen to work together to improve the bone health of our patients. Often, the patients are only focused on their current injury and we help them realise there is so much more to it. It is very rewarding to have a patient come back after 12 months, having made changes to their diet or exercise routines and, importantly, taking regular medication for their bone health and seeing an improvement in their bone density t-scores and their physical ability.

What tips do you have for others?

  • There needs to be an understanding between all staff that different skills and approaches can work well together to deliver excellent patient care.
  • Before you start, ensure that administration support is part of your staff profile. This ensures the efficient running of the service and appointment system, and enables clinicians to focus on clinical work.
  • Don't re-invent the wheel, share resources.

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