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Fracture Liaison Coordinator, Osteoporosis Canada

Grey/Bruce Region, Ontario
Deadline March 19, 2014

Osteoporosis Canada, a registered charity, is the only national organization serving people who have, or are at risk for, osteoporosis. OC works to educate, empower and support individuals and communities in the prevention and treatment of osteoporosis.

Background:

Osteoporosis is a disease characterized by low bone mass and deterioration of bone tissue.  This can cause the skeleton to become fragile, so that even a slight bump or fall, from standing height or less, can lead to a broken bone (referred to as a fragility fracture). Osteoporosis has  no signs or symptoms until a fracture occurs – this is why it is often called a  "silent disease."

Osteoporosis affects all bones in the body; however, fractures occur most frequently in the vertebrae (spine), wrist and hip. Osteoporotic fractures of the pelvis, upper arm and lower leg are also common. Osteoporosis itself is not painful but the broken bones can result in severe pain, significant disability and even mortality. Both hip and spine fractures are also associated with a higher risk of death. Twenty-eight per cent of women and 37% of men who suffer a hip fracture will die within the year following the fracture.

In Canada, the risk of a major osteoporotic fracture is one of the highest in the world. Each year 30,000 Canadians break their hip with many more Canadians suffering from osteoporotic fractures affecting the spine, wrist, shoulder, and pelvis. Over 80% of all fractures after age 50 are caused by osteoporosis. Despite availability of BMD testing and coverage for osteoporosis medications, over 80% of fracture patients are never offered assessment and/or treatment for osteoporosis post fracture. Without appropriate diagnosis and treatment, these patients remain at substantial risk for recurrent, debilitating and life threatening osteoporotic fractures.

In 2010/11, Ontarians sustained over 53,000 osteoporotic fractures and in 2011/12, there were over 12,000 hospital admissions for hip fractures in Ontario. Men and women who have had a fragility fracture are at an increased risk of having another fracture. Along with this, the risk of sustaining a fracture increases exponentially with age, due not only to the decrease in bone mineral density, but also to the increased rate of falls among the elderly. As the population is aging, it is anticipated that there will be a significant increase in the number of fragility fractures, particularly hip fractures, in the coming years. These fractures will affect many more individuals and their families and will have a significant impact on costs to the health care system.

In February 2005, the Ministry of Health and Long-Term Care announced Ontario’s first Osteoporosis Strategy, supported by $5 million in annual funding. The goal of the Strategy is to reduce morbidity, mortality and costs from osteoporotic fractures using a patient centred, multi-disciplinary approach that is integrated across health care sectors, with an overall goal to reduce osteoporotic hip fractures in Ontario by 20% by 2020.

The integration of post fracture care is a key component to achieving this goal. Fracture Liaison Coordinators, as part of the Regional Fracture Prevention Program within the Ontario Osteoporosis Strategy at Osteoporosis Canada, work to identify people with moderate or high fracture risk and facilitate appropriate treatment and care to help reduce the risk of a future fracture.

Job Summary:

The role of the Fracture Liaison Coordinator, in an effort to prevent subsequent fractures, including hip fractures, is to identify and screen patients aged 50 or older who have sustained a fragility fracture. Patients will have attended an emergency department or orthopaedic/fracture clinic in Grey/Bruce region.

The Coordinator will screen fragility fracture out-patients via phone and provide appropriate information and support to connect these patients with primary care, community-based services and education and referral, as appropriate. The Coordinator will also work with orthopaedic surgeons, allied health professionals, fracture clinic staff and primary care to help improve patient access to integrated post-fracture care for osteoporosis investigation and management. The Coordinator is expected to inform patients of the need to follow up with their family physicians, nurse practitioners and/or osteoporosis specialists after a fracture, for osteoporosis assessment, treatment and reducing the risk of future fracture.

The Fracture Liaison Coordinator will facilitate specified case findings within the primary care setting to identify patients who may be at risk for a future fracture, and implement appropriate interventions to help reduce this risk. Along with this, the Coordinator will support the adoption of an osteoporosis Electronic Medical Records (EMR) module within the primary care setting.

The Fracture Liaison Coordinator reports to the Regional Integration Lead, Ontario Osteoporosis Strategy, Osteoporosis Canada.

Qualifications:  

Registered Practical Nurse (RPN) or Registered Nurse (RN)

Other Essential Attributes:

Experience working with Electronic Medical Records (EMR) and computer proficiency, including Microsoft Office, a must. Excellent oral and written communication skills; ability to work independently, with initiative and with limited supervision; ability to work as part of a diverse team and the ability to demonstrate sensitivity to the needs of patients. Second language an asset.

Responsibilities:

  • Diligent use of protocol tools to identify and screen fragility fracture patients aged 50 or older, collect patient data and provide patients with appropriate referrals, information and educational resources.
  • Facilitate diagnostic testing for identified patients, as appropriate.
  • Ensure appropriate follow up by a primary care physician or specialist as required.
  • Responsible for collating data, ensuring security of data collection tools and the database.
  • Discuss with patients and/or caregivers the significance of bone health, risk factors for fractures, osteoporosis, falls and management of osteoporosis, as appropriate.
  • Encourage patients to discuss bone health with their health care providers.
  • Link patients to appropriate education and self-management programs.
  • Communicate with the patients’ family physicians to inform them about their patients’ osteoporosis and/or fracture risk; outline appropriate recommendations.
  • Provide orphan patients with a resource to help link them to a primary care provider.
  • Follow up with identified patients between 3 and 7 months post baseline screening.
  • Provide regular program updates to the Regional Integration Lead.
  • Assist the Regional Integration Lead in providing ongoing support and education to hospital, community and primary health care staff, highlighting the link between osteoporosis, fragility fractures and future fracture risk as well as the importance of their role, as staff, in helping to reduce re-fractures.
  • Regular use of various computer applications, including EMRs and other data collection tools.
  • Support primary care staff with the integration and use of an osteoporosis EMR module.
  • Provide appropriate interventions to at-risk patients identified through the case finding process.
  • Provide periodic aggregate case finding reports to the Regional Integration Lead.
  • Other duties as assigned.

Area of Work

Placement in an acute community or primary care centre within Grey/Bruce region. Some travel will be required.

Submit resume and cover letter by March 19, 2014 to: Jennifer Weldon, Program Manager, Fracture Clinic Screening Program at [email protected].

No calls please. Only those candidates selected for an interview will be contacted.