The effectiveness of implementing a fracture liaison service in Egypt: A quality improvement study.

Background: Fractures are one of the major health problems in the older population, having a significant impact on overall health, and quality of life. Fracture liaison services (FLS) are recommended as a model of best practice. Aims: To determine the effectiveness of implementing an FLS. Design: This was a quality improvement study set in our facility in Ain Shams University hospitals. Methods: We compared fracture care and outcomes before and after the implementation of FLS in terms of time to surgery, length of stay, pre-and postoperative pain scores, depression, and treatment decisions. We included 130 patients, aging above 60 years presenting by fracture to the emergency department. Results: We found that there was a significant reduction in the median time to surgery in the post FLS group (p value < 0.001), and also a significant decrease in the mean length of stay in favor of the group post FLS, with p value < 0.001. But there wasn’t a significant difference between the two groups regarding the number of patients that underwent surgical correction, pre-and post-operative pain, or susceptibility to depression. Conclusion: Since the beginning of our FLS unit, the preliminary data have been encouraging, with significant reductions in time to surgery and length of stay. Because there is poor patient compliance to post-discharge follow-up, we were not able to accurately measure time to medical clearance and return to previous activity and functional levels.