Form C: Annual Enrolment (Apr 1, 2022 to Mar 31, 2023) & Cohort Apr 1, 2022 to Sep 30, 2022 follow up-KPI 1 & KPI 2 (Spring 2023)

Step 1 of 6

16%

Section 1: Information about your FLS
Within OC’s FLS Registry and for the purposes of this audit, FLSs are assessed by individual hospital sites. For hospital corporations which may operate an FLS at two or more separate sites, a separate submission form must be filled out for each individual FLS site. For any questions in filling out this questionnaire, please contact Luanne Schenkels at lschenkels@osteoporosis.ca
FLS site information
Person submitting this form:
First name Last name
Email of submitter
1. Name of your hospital/site, exactly as it should appear on the OC FLS Registry:

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Section 2: Annual FLS enrollment reporting:
a. How many fragility fracture patients (aged 50 and up) were newly enrolled in your FLS between April 1, 2022 and March 31, 2023?
b. i) Of the patients in "a" (above), how many were hip (proximal femur) fractures?
b. ii) Of the patients in "a" (above), how many were wrist (distal radius) fractures?
b. iii) Of the patients in "a" (above), how many were shoulder (proximal humerus) fractures?
b. iv) Of the patients in "a" (above), how many were pelvic fractures?
b. v) Of the patients in "a" (above), how many were spine/vertebral fractures?
b. vi) Of the patients in "a" (above), how many were other fracture types?
Please list other fracture types (if applicable):
Please list other fracture types (if applicable):

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Section 3: FLS Audit
1. Our FLS type:
(Click only one answer)
- A. Inpatient-only FLS (i.e. the FLS coordinator first meets the patient directly on the orthopaedic inpatient ward). Our FLS enrolls only hip fracture patients.
- B. Inpatient-only FLS (i.e. the FLS coordinator first meets the patient directly in the inpatient ward). Our FLS enrolls more than just hip fracture patients.
- C. Outpatient only FLS (i.e. the FLS coordinator first meets the patient directly in the orthopaedic outpatient clinics).
- D. Combined inpatient/outpatient FLS (i.e. the FLS coordinator does systematic and pro-active case finding both on the orthopaedic inpatient ward AND in the orthopaedic outpatient clinics. Some patients, e.g. hip fracture patients, are first seen in person while still on the orthopaedic ward and others, e.g. wrist fracture patients, are first seen in person during their visit to the orthopaedic outpatient clinic).
- E. Other
If you have clicked on 'e" above, before going any further with this questionnaire...
...please provide a brief overview of your program to Luanne Schenkels at Lschenkels@osteoporosis.ca and you will be contacted promptly with guidance for your specific program.
Other, please desribe:

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2. In most hospitals, there is a fairly constant relative proportion of hip fractures to other fracture types (e.g. wrist, shoulder, etc). In regards to your hospital, is there any reason why you believe this typical proportion would not apply?
- My hospital admits all of the hip fracture patients for a larger geographic region which includes other orthopaedic hospitals where fracture patients are only seen in the outpatient orthopaedic clinics.
- My hospital has outpatient orthopaedic clinics, but all/most hip fracture surgery is done at another orthopaedic hospital in my district.
- Other, please describe:
If other, please describe:
A: Inpatient-only FLS (i.e. the FLS coordinator first meets the patient directly on the orthopaedic inpatient ward). Our FLS enrolls only hip fracture patients.
Please refer to OC’s FLS KPIs v3.0 document for any details regarding the numbers to be reported in this audit. You may access the KPIs by copying this link into your browser: https://fls.osteoporosis.ca/indicator/
A.1. How many hip fracture patients were admitted to (or discharged from) your hospital from April 1st, 2022 to September 30, 2022? This data must be from an administrative database independent of your FLS.
A.2. From April 1, 2022 to September 30, 2022, how many fragility hip fracture patients (aged 50 and up) were newly enrolled in the FLS (i.e. first seen by the FLS coordinator) within 6 weeks of their hip fracture?
A.3. Of the patients listed in A.2. above:
A.3.a. How many were initiated (or continued) on first-line osteoporosis medication (alendronate, risedronate, zoledronic acid, denosumab or teriparatide) within 26 weeks of their hip fracture?
A.3.b. How many were not initiated a first-line osteoporosis medication within 26 weeks of their hip fractures?
A.3.b. How many were not initiated a first-line osteoporosis medication within 26 weeks of their hip fractures?
A.3.c. How many are you not sure if the patient was initiated or not on osteoporosis medication within 26 weeks (e.g. patient lost to follow-up)?
A.3.c. How many are you not sure if the patient was initiated or not on osteoporosis medication within 26 weeks (e.g. patient lost to follow-up)?
A.4. How is treatment initiation ascertained for the majority (> 50%) of HIGH RISK patients in your FLS?
(Click only one answer)
- a. Our FLS provides the prescription to the patient directly.
- b. Patient self-report upon follow-up visit or phone call.
- c. Medication has been dispensed as per a pharmaceutical or administrative database. Please specify database.
- d. Other
Please provide details (if indicated):
Please provide details (if indicated):
B: Inpatient-only FLS (i.e. the FLS coordinator first meets the patient directly on the orthopaedic inpatient ward). Our FLS enrolls more than just hip fracture patients.
Please refer to OC’s FLS KPIs v3.0 document for any details regarding the numbers to be reported in this audit. You may access the KPIs by copying this link into your browser: https://fls.osteoporosis.ca/indicator/
B.1. How many hip fracture patients were admitted to (or discharged from) your hospital from April 1st, 2022 to September 30, 2022? This data must be from an administrative database independent of your FLS.
B.2. From April 1, 2022 to September 30, 2022, how many fragility fracture patients (aged 50 and up) were newly enrolled in the FLS (i.e. first seen by the FLS coordinator) within 6 weeks of their fracture?
a. Hip (proximal femur) fractures
b. Wrist (distal radius) fractures
b. Wrist (distal radius) fractures
c. Shoulder (proximal humerus) fractures
c. Shoulder (proximal humerus) fractures
d. Pelvic fractures
d. Pelvic fractures
e. Spine/vertebral fractures
e. Spine/vertebral fractures
B.3. Of the total non-spine fracture patients listed in 2f above, number of patients where the fracture risk was determined within 26 weeks to be:
a. HIGH RISK
b. MODERATE RISK
b. MODERATE RISK
c. LOW RISK
c. LOW RISK
d. Fracture risk could not be determined within 26 weeks
d. Fracture risk could not be determined within 26 weeks
B.4. Of the HIGH RISK patients listed in C.3.a above:
B.4.a. How many were initiated (or continued) on first-line osteoporosis medication (alendronate, risedronate, zoledronic acid, denosumab or teriparatide) within 26 weeks of their fracture?
B.4.b. How many were not initiated a first-line osteoporosis medication within 26 weeks of their fractures?
B.4.b. How many were not initiated a first-line osteoporosis medication within 26 weeks of their fractures?
B.4.c. How many are you not sure if the patient was initiated or not on osteoporosis medication within 26 weeks (e.g. patient lost to follow-up)?
B.4.c. How many are you not sure if the patient was initiated or not on osteoporosis medication within 26 weeks (e.g. patient lost to follow-up)?
B.5. How is treatment initiation ascertained for the majority (> 50%) of HIGH RISK patients in your FLS?
(Click only one answer)
- a. Our FLS provides the prescription to the patient directly.
- b. Patient self-report upon follow-up visit or phone call.
- c. Medication has been dispensed as per a pharmaceutical or administrative database. Please specify database.
- d. Other
Please specify database or other details:
Please specify database or other details:
C: Outpatient-only (i.e. the FLS coordinator first meets the patient directly in the orthopaedic outpatient clinics)
Please refer to OC’s FLS KPIs v3.0 document for any details regarding the numbers to be reported in this audit. You may access the KPIs by copying this link into your browser: https://fls.osteoporosis.ca/indicator/
C.1. How many hip fracture patients were admitted to (or discharged from) your hospital from April 1st, 2022 to September 30, 2022? This data must be from an administrative database independent of your FLS.
C.2. From April 1, 2022 to September 30, 2022, how many fragility fracture patients (aged 50 and up) were newly enrolled in the FLS (i.e. first seen by the FLS coordinator) within 12 weeks of their hip fracture and within 6 weeks for non hip fractures?
a. Hip (proximal femur) fractures (within 12 wks)
b. Wrist (distal radius) fractures (within 6 wks)
b. Wrist (distal radius) fractures (within 6 wks)
c. Shoulder (proximal humerus) fractures (within 6 wks)
c. Shoulder (proximal humerus) fractures (within 6 wks)
d. Pelvic fractures (within 6wks)
d. Pelvic fractures (within 6wks)
e. Spine/vertebral fractures
e. Spine/vertebral fractures
C.3. Of the total non-spine fracture patients listed above, number of patients where the fracture risk was determined within 26 weeks to be:
a. HIGH RISK
b. MODERATE RISK
b. MODERATE RISK
c. LOW RISK
c. LOW RISK
d. Fracture risk could not be determined within 26 weeks
d. Fracture risk could not be determined within 26 weeks
C.4. Of the HIGH RISK patients listed in 3a above,
a. How many were initiated (or continued) on first-line osteoporosis medication (alendronate, risedronate, zoledronic acid, denosumab or teriparatide) within 26 weeks of their fracture?
b. How many were not initiated a first-line osteoporosis medication within 26 weeks of their fractures?
b. How many were not initiated a first-line osteoporosis medication within 26 weeks of their fractures?
c. How many are you not sure if the patient was initiated or not on osteoporosis medication within 26 weeks (e.g. patient lost to follow-up)?
c. How many are you not sure if the patient was initiated or not on osteoporosis medication within 26 weeks (e.g. patient lost to follow-up)?
C.5. How is treatment initiation ascertained for the majority (> 50%) of HIGH RISK patients in your FLS?
(Click only one answer)
- a. Our FLS provides the prescription to the patient directly.
- b. Patient self-report upon follow-up visit or phone call.
- c. Medication has been dispensed as per a pharmaceutical or administrative database. Please specify database.
- d. Other
Please specify database or other:
Please specify database or other:
D: Combined inpatient/outpatient FLS (i.e. the FLS coordinator does systematic and pro-active case finding both on the orthopaedic inpatient ward AND in the orthopaedic outpatient clinics).
Please refer to OC’s FLS KPIs v3.0 document for any details regarding the numbers to be reported in this audit. You may access the KPIs by copying this link into your browser: https://fls.osteoporosis.ca/indicator/
D.1. How many hip fracture patients were admitted to (or discharged from) your hospital from April 1st, 2022 to September 30, 2022? This data must be from an administrative database independent of your FLS.
D.2. From April 1, 2022 to September 30, 2022, how many fragility fracture patients (aged 50 and up) were newly enrolled in the FLS (i.e. first seen by the FLS coordinator) within 12 weeks of their hip fracture and 6 weeks of their non hip fracture?
a. Hip (proximal femur) fractures (within 12 wks)
b. Wrist (distal radius) fractures (within 6 wks)
b. Wrist (distal radius) fractures (within 6 wks)
c. Shoulder (proximal humerus) fractures (within 6 wks)
c. Shoulder (proximal humerus) fractures (within 6 wks)
d. Pelvic fractures (within 6 wks)
d. Pelvic fractures (within 6 wks)
e. Spine/vertebral fractures
e. Spine/vertebral fractures
D.3. Of the total non-spine fracture patients listed above, number of patients where the fracture risk was determined within 26 weeks to be:
a. HIGH RISK
b. MODERATE RISK
b. MODERATE RISK
c. LOW RISK
c. LOW RISK
d. Fracture risk could not be determined within 26 weeks
d. Fracture risk could not be determined within 26 weeks
D.4. Of the HIGH RISK patients listed in 3a above:
a. How many were initiated (or continued) on first-line osteoporosis medication (alendronate, risedronate, zoledronic acid, denosumab or teriparatide) within 26 weeks of their fracture?
b. How many were not initiated a first-line osteoporosis medication within 26 weeks of their fractures?
b. How many were not initiated a first-line osteoporosis medication within 26 weeks of their fractures?
c. How many are you not sure if the patient was initiated or not on osteoporosis medication within 26 weeks (e.g. patient lost to follow-up)?
c. How many are you not sure if the patient was initiated or not on osteoporosis medication within 26 weeks (e.g. patient lost to follow-up)?
D.5. How is treatment initiation ascertained for the majority (> 50%) of HIGH RISK patients in your FLS?
(Click only one answer)
- a. Our FLS provides the prescription to the patient directly.
- b. Patient self-report upon follow-up visit or phone call.
- c. Medication has been dispensed as per a pharmaceutical or administrative database. Please specify database.
- d. Other
Please specify database or other:
Please specify database or other:

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Section 4: Osteoporosis Canada and your site
1. How can Osteoporosis Canada help/support your FLS?

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Section 5: Permission
Thank you for your collaboration. By submitting the FLS Registry Renewal form, you are authorizing Osteoporosis Canada (OC) to include the information provided within an aggregate overview of FLS in Canada.

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Step 1 of 6

Section 1: Information about your FLS

FLS site information

Section 2: Annual FLS enrollment reporting:

Section 3: FLS Audit

If you have clicked on 'e" above, before going any further with this questionnaire...

A: Inpatient-only FLS (i.e. the FLS coordinator first meets the patient directly on the orthopaedic inpatient ward). Our FLS enrolls only hip fracture patients.

B: Inpatient-only FLS (i.e. the FLS coordinator first meets the patient directly on the orthopaedic inpatient ward). Our FLS enrolls more than just hip fracture patients.

C: Outpatient-only (i.e. the FLS coordinator first meets the patient directly in the orthopaedic outpatient clinics)

D: Combined inpatient/outpatient FLS (i.e. the FLS coordinator does systematic and pro-active case finding both on the orthopaedic inpatient ward AND in the orthopaedic outpatient clinics).

Section 4: Osteoporosis Canada and your site

Section 5: Permission