ACR Meeting Abstracts

ACR Meeting Abstracts

  • Meetings
    • ACR Convergence 2024
    • ACR Convergence 2023
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • ACR Meetings

Abstract Number: 0125

A Resident-Led Interdisciplinary Quality Improvement Initiative to Increase Osteoporosis Screening in an Urban Clinic

Catherine Teskin1 and Hiba Sayed2, 1Christiana Care, Wilmington, 2Christiana Care, wilmington, DE

Meeting: ACR Convergence 2020

Keywords: Access to care, Bone density, Clinical Osteoporosis, Fracture, osteoporosis

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print
Session Information

Date: Friday, November 6, 2020

Title: Osteoporosis & Metabolic Bone Disease Poster

Session Type: Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: Osteoporosis is a major cause of morbidity and mortality in the United States. The USPSTF recommends screening all women age 65 and older or younger women with risk factors for osteoporosis.[2] Unfortunately, osteoporosis screening rates remain low nationwide.[3] In our residency clinic, the baseline screening rate for women age 65 and older was 47%. We aimed to increase this rate by 10% over a three month period.

Methods: Our root cause analysis identified provider, patient, and system level barriers to osteoporosis screening. Plan-Do-Study-Act (PSDA) cycle 1 targeted provider knowledge through didactic education and posters in the clinic space. PDSA cycle 2 identified patient barriers. We collaborated with an institutional nurse-led program called “Strong Bones” that has existing initiatives in place to detect and treat osteoporosis. We used a health registry embedded within our electronic medical record to identify patients from our clinic who were eligible for osteoporosis screening. A Strong Bones nurse then reached out to each patient to explain the need for screening and to help navigate barriers. We then tracked the rate of osteoporosis screening between PDSA cycles through the health registry and manually reviewed patient level data during a three month patient outreach period.

Results: After PDSA cycle 1, we saw a slight increase in our screening rate from a baseline of 46% (101/216) to 49% (106/216). During PDSA cycle 2, we identified and chose 138 patients eligible for osteoporosis screening to be contacted. 71 of these patients were called during the outreach period, and 11 scans were completed. Our screening rate at the beginning of cycle 2 was 34% (111/322) and increased to 36% (122/338). The most common barrier identified during this period was patient disinterest, though many were unreachable.

Conclusion: Results from PDSA-1 showed that resident education alone increased the number of DEXA scans ordered, but did not substantially increase completed screenings due to patient barriers. Furthermore, relying on “inreach” interventions targeting only the patients present at the office visit missed a large proportion the patient panel. PDSA cycle 2 addressed both of these issues. There was a substantial increase in DEXA completion and we were also able to quantify the barriers our patients faced in the process. Limitations included difficulty in obtaining reliable data. Additionally, ongoing changes to the health registry’s patient attribution characteristics led to a lower rate of completed screening even though the total number of screenings increased. Although our intervention led to more patients having their screening completed, it was very time-intensive and would be difficult to sustain moving forward. Next steps consist of identifying ways to decrease system level barriers, such as through streamlined scheduling and same day appointments.

Completion Percentage of Osteoporosis Screening/DEXA Scans Over Time


Disclosure: C. Teskin, None; H. Sayed, None.

To cite this abstract in AMA style:

Teskin C, Sayed H. A Resident-Led Interdisciplinary Quality Improvement Initiative to Increase Osteoporosis Screening in an Urban Clinic [abstract]. Arthritis Rheumatol. 2020; 72 (suppl 10). https://acrabstracts.org/abstract/a-resident-led-interdisciplinary-quality-improvement-initiative-to-increase-osteoporosis-screening-in-an-urban-clinic/. Accessed .
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

« Back to ACR Convergence 2020

ACR Meeting Abstracts - https://acrabstracts.org/abstract/a-resident-led-interdisciplinary-quality-improvement-initiative-to-increase-osteoporosis-screening-in-an-urban-clinic/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

Violation of this policy may result in the abstract being withdrawn from the meeting and other measures deemed appropriate. Authors are responsible for notifying colleagues, institutions, communications firms, and all other stakeholders related to the development or promotion of the abstract about this policy. If you have questions about the ACR abstract embargo policy, please contact ACR abstracts staff at [email protected].

Wiley

  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences

© Copyright 2025 American College of Rheumatology