Own the Bone Program Spotlight
Norton Women’s and Children’s Hospital

                                                                       
 Kim Kisegy, APRN, ONP-C Cynthia Preston, RN, Nurse Liaison
 Norton Orthopedic Services                           Norton Women’s & Children’s Hospital

Louisville, KY

Can you tell us a little bit about Norton? 

Norton Women’s & Children’s Hospital is the champion facility for the Own the Bone program within Norton Healthcare. This facility is a 373-bed acute care hospital with 2,100 employees providing care through the more than 139,600 patient encounters annually. The hospital is part of the Norton Healthcare system. The system overall has more than 2.6 million patient encounters in both adult and pediatric care annually. The physicians and advanced level providers through Norton Orthopedic Services support the initiative and are a leading force in the expansion of the program for both inpatient and outpatient encounters.
 

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

Charlotte Ipsan, chief administrative officer at Norton Women’s & Children’s Hospital, is very passionate about improving the overall health and well-being of our patients. It is her vision to expand the orthopedic service line to include bone health education. In 2013, a multidisciplinary team composed of a project manager, a member of senior leadership, an orthopedic surgeon, and a nurse liaison, gathered to decide the direction of our program, particularly focused on improving fracture care through a fracture fragility program in our in-patient setting.  This led us through a web search where we found the Own the Bone website. Own the Bone seemed to be the perfect fit for our goals. The program allows us to have access to patient education and speakers, while also providing us with a web registry to monitor our process as we collected data. 

What does your current Own the Bone Program look like? 

The goal of the program is to capture any fracture over the age of 50 in the in-patient setting.  

Currently, our program is managed by our bone health champions, Kim Kisegy APRN, ONP-C, and Cynthia Preston, RN, nurse liaison. Our order set calls for either Kim or Cynthia to be consulted through our hospitalist group to see all patients with fractures over the age of 50; or Kim or Cynthia obtain referrals from orthopedic surgeons.  While consulting with patients in the hospital, our nurse liaison provides patients education on bone health including the importance of:
  • Taking calcium and vitamin D supplements 
  • Smoking cessation
  • Reducing alcohol consumption 
  • Falls prevention
  • Follow up bone mineral density testing 
Simultaneously our nurse practitioner will order the necessary lab work and make the out-patient referrals as appropriate to the patient’s primary care provider. If the patient does not have a primary care provider, our team will assist them in securing a provider and then work with our network of dedicated specialty providers such as non-surgical orthopedics, endocrinology or rheumatology to schedule the appropriate follow up appointments. 

Research shows that successful recovery and a reduction in additional fractures is dependent on patients following up on their care with their primary providers. To support this effort, once a patient is discharged from the hospital, our nurse liaison calls the patient at 30 days and again between 60 to 90 days. The nurse liaison will ask the patient if they are taking medication if appropriate, checking to see if they had a DEXA scan or if they have followed up with a provider for their bone health.  

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

Norton Women’s & Children’s Hospital is part of the Norton Healthcare system. Overall there are four adult acute care facilities and it is our goal to expand our program into the remaining three adult hospitals. Future considerations for our program will include:
  • Broadening our program to emergency and outpatient services to capture the non-surgical upper extremity fractures and compression fractures.  
  • Continuing our efforts to provide community education by providing community lectures as well as increasing our referral base for patients being seen in our non-surgical orthopedic offices for osteoporosis screening 
 ​

Any takeaways or advice for other sites? 

As with starting any program, you have to have the support. Our team was very fortunate to have support across all areas of the hospital from senior leadership and the medical staff.  

Published July 2017
  
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