Own the Bone Program Spotlight
Froedtert Hospital
Milwaukee, WI


   
 Sara Arndt    Erin Zepezauer
 MSN, APRN, ACCNS-AG, APNP    MSN, APNP

 

Can you tell us a little bit about Froedtert Hospital?

Froedtert Hospital is a 585-bed, academic medical center in the Milwaukee area. It serves as the region’s only adult Level I Trauma Center. Affiliated with the Medical College of Wisconsin, Froedtert Hospital serves as a major training facility for medical, nursing, and health tech students. Additionally, Froedtert and the Medical College of Wisconsin participate in nearly 2000 research studies each year.

 

How did you get started with your Own the Bone program?

Orthopaedic surgeon and current Own the Bone Program Champion at Froedtert Hospital, Dr. Joseph Schwab, became interested in creating an FLS program after attending an AAOS FLS Symposium where Own the Bone was mentioned. Both he and current Program Coordinator Sara Arndt, APNP, brought information regarding Own the Bone back to their Executive Leadership. This information was used to form an interdisciplinary team that would consult and manage the initiation of Own the Bone. The team included representation from Orthopaedics, Endocrinology, Interventional Radiology, Neurosurgery (Spine Care), Internal Medicine, nutrition, and therapy.

 

What does your current Own the Bone program look like?

Currently the day-to-day operations of the team are handled by Sara, and a second Program Coordinator, Erin Zepezauer, APNP. Sara focuses on seeing patients who are currently admitted to the hospital, while Erin focuses on seeing patients in the clinic. Both Erin and Sara share responsibilities of the program, such as entering data into the registry, which means that open and clear communication is important to the successful implementation of Own the Bone.

Initially, the program focused on capturing inpatient hip fractures through an automatic ED order set that also requested bone health screening labs. As our program has grown, we continue to update our processes in an effort to capture all fragility fracture patients. Once a patient is identified, Sara will try to see the patient by post-op day 1-3. During this time, Sara completes a comprehensive bone health assessment and gathers any information that could give insight to the patient’s risk for osteoporosis. She also goes over the two page Own the Bone Patient Education Flyer with each patient. Upon discharge patients are given a recommendation for calcium or vitamin D supplements and a prescription for a BMD test. After the initial meeting, Sara will either schedule a patient’s follow-up appointment or place a referral to have a scheduling coordinator contact the patient to help them arrange their follow-up appointment in the clinic with Erin. This appointment is usually around their 6-week surgical follow-up. We try very hard to arrange this on the same day as the appointment with their surgeon to avoid making the patient come in on multiple  days. During their clinic appointment, Erin will review the results of the BMD testing, review calcium and vitamin D recommendations, and then discuss pharmacologic treatment options with the patient. Sara and Erin utilize a Sharepoint website as a communication tool to pass along pertinent patient information. By talking with patients while in the hospital and then again in the clinic, Sara and Erin have found that patients are able to retain more information about how they can improve their bone health. 

 

How do you hope to grow your program in the future?

Although our program has seen such great success in the few short months since we’ve enrolled, we are already looking for ways we can continue to grow our program. While Own the Bone is currently housed in the academic medical center, Froedtert Hospital is part of a regional health network that includes community hospitals and clinics. Our team has been tracking where our patients are coming from to create a “heat map” of the community so that we can later provide a recommendation on where Own the Bone should be expanded to within the community.

 

What advice do you have for other sites?

The key is interdisciplinary support. In growing our program we had a lot of assistance from other departments, including Endocrinology. We routinely refer patients with complex needs to Endocrinology for their expert care. We also have a good relationship with Interventional Radiology and Neurosurgery (Spine Care); they will send referrals to our program if they notice a patient has not had a workup for their osteoporosis. Another important line of communication is with the patient’s primary care provider. We speak with them very frequently to make sure they are comfortable with our plan of care, and in return they have been a great help in reinforcing the continued need for osteoporosis care with the patient. Our various key stakeholders also didn’t stop being involved once the program came to fruition – they are still very much engaged with Own the Bone through monthly meetings in which the full team reviews program metrics, compliance with Own the Bone measures, and thoughts on how we can continue to grow the program.
 
Published April 2018
  
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