[AVBC 2025] Enhance Osteoporosis Management in Geriatric Inpatients with workflow initiative by APCO Framework
Care Continuum
Care Process & Redesign
Appropriate & Value-based Care Conference
SingHealth
21 November 2025
The project aimed to increase comprehensive osteoporosis management rates for eligible patients from a baseline of 8% to 70%. This initiative demonstrated that a structured, multidisciplinary approach can significantly enhance inpatient osteoporosis.
Year Submitted: 2025
Published Date: 21 November 2025
Tags: Care Process ＆ Redesign, Care Continuum, Quality Improvement, Workflow Redesign, Preventive Care, Patient Education
About this Content
Aims
The project aimed to increase comprehensive osteoporosis management rates for eligible patients from a baseline of 8% to 70% within 3 months post-intervention.
Background
In Singapore, osteoporosis prevalence reaches 19.4% in postmenopausal women, and fragility fractures are expected to increase by 58% by 2035. Despite this, inpatient osteoporosis care remains inadequate. Critical gaps in osteoporosis management were identified in ward 63 of Singapore General Hospital.
Methods
A cause-and-effect diagram was used to identify contributing factors to low management rates. A Pareto chart prioritized four key root causes: poor awareness and knowledge among junior doctors, lack of standardized workflows, inadequate patient/family education, and inpatient dental clearance challenges.
Results
Comprehensive osteoporosis management rates improved from 7% to 80%.
Conclusion
This initiative demonstrated that a structured, multidisciplinary approach can significantly enhance inpatient osteoporosis management, highlighting the need to proactively address osteoporosis, a condition that is often underrecognized and undertreated during inpatient care.
Lessons Learnt
The initiative significantly improved inpatient osteoporosis identification and management, enhanced junior doctors confidence in managing the disease, and improved patient/family awareness and knowledge of osteoporosis. However, most patients were not started on osteoporosis medication prior to discharge due to dental clearance requirements.
Keywords
Osteoporosis, Management, Workflow, Education, Geriatric
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | SingHealth |
Organization(s) Involved | Singapore General Hospital |
Platform(s) | Appropriate & Value-based Care Conference |
Healthcare Professional Group(s) | Nursing |
Applicable Specialty or Discipline | Geriatric Medicine, Orthopaedics, Dental / Dentistry |
Project Lead(s) | Huang Xiaofeng |
Project Member(s) | Huang Xiaofeng |
Connect with this contributor!
Huang Xiaofeng - huang.xiaofeng@sgh.com.sg