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Fracture Liaison Service Database (FLS-DB) Improvement Repository

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All key performance indicators (KPIs) measure performance against technology assessments, guidance on osteoporosis and clinical standards for FLSs from NICE, the ROS and the NOGG. 

The KPIs for the FLS-DB are as listed below. National and service level figures can be viewed in the FLS-DB annual reports. 

Collaboration is key to improvement. As such, we have created a platform for services to share improvement stories. In the downloads section, a series of case studies have been grouped by KPI. There is also a case study template for services to complete and send to flsdb@rcplondon.ac.uk. The information provided will be written as a narrative and returned to you for approval before being published.

In order to measure the effectiveness of the changes you choose to implement, we recommend using the Statistical Process Control (SPC) Tool (accessible via the button on the right). 

Key Performance Indicators (KPIs)

KPI 1 – Data completeness
FLSs with good level of data completeness (Defined as fewer than five fields with more than 20% of data missing).

KPI 2 – Identification (all fragility fractures)
Percentage of patient records submitted compared with the local estimated caseload.

KPI 3 – Identification (spinal fractures)
Percentage of patients with a spine fracture as their index fracture site.

KPI 4 – Time to FLS assessment
Percentage of patients who were assessed by the FLS within 90 days of their fracture.

KPI 5 – Time to DXA
Percentage of patients who had a DXA ordered or recommended and were scanned within 90 days of fracture.

KPI 6 – Falls assessment
Percentage of patients who received a falls assessment or were referred or recommended for a falls assessment.

KPI 7 – Bone therapy recommended
Percentage of patients who were recommended anti-osteoporosis medication.

KPI 8 – Strength and balance training
The percentage of non-hip fracture patients who had started strength and balance training within 16 weeks of their fracture (In 2016 this was calculated for all fractures, from 2017 it was for hip fractures alone).

KPI 9 – Monitoring contact 12–16 weeks post fracture
The percentage of patients who were followed up following their fracture.

KPI 10 ­– Commenced bone therapy by first follow up
The percentage of patients who had commenced (or were continuing) anti-osteoporosis medication.

KPI 11 – Adherence to prescribed anti-osteoporosis medication at 12 months post fracture
The percentage of patients who had confirmed adherence to a prescribed anti-osteoporosis medication at 12 months post fracture.