Greater Glasgow & Clyde Fracture Liaison Service
A case study
Executive Summary
Red Star FLS collaborated with NHS Greater Glasgow and Clyde (NHS GG&C) to implement a modern Fracture Liaison Service (FLS) system. This partnership aimed to address inefficiencies in the identification and treatment of fragility fractures.
Through the introduction of Red Star FLS, NHS GG&C saw significant improvements in fracture identification, patient enrollment in FLS programs, and overall efficiency in fracture care. The implementation resulted in a reduced backlog of scans, quicker initiation of treatment, and better resource utilization, leading to cost savings and better patient outcomes.
Introduction
NHS Greater Glasgow and Clyde faced challenges in managing fragility fractures due to the limitations of their existing systems. Delays in identifying fractures, especially non-hip fractures, and a backlog of unprocessed scans were causing inefficiencies. The need for a more streamlined and automated process became evident. Red Star FLS, a modern system designed to improve the efficiency of fracture care, was introduced to address these issues. The system was designed in collaboration with NHS partners, aiming to enhance the identification and management of fractures while integrating seamlessly with existing NHS systems.
The Challenge
Before the implementation of Red Star FLS, NHS GG&C struggled with several key issues:
Missed Fractures
The existing system often missed a significant number of reported fractures, leading to delayed or missed identification and treatment.
Backlog of Scans
A significant backlog of unprocessed scans meant that patients were not being enrolled in the FLS promptly.
Labour-Intensive Processes
The manual nature of the existing system was time-consuming for staff and prone to errors, reducing overall efficiency.
Long Time to Fracture Identification
The average time to non-hip fracture identification was 15 months for GGC SS (24 months for the whole of GGC)
No Integrated Audit Tool
No information on how the system is performing against national standards
Outdated Microsoft Access database
Outdated technology did not support a modern FLS
These issues resulted in delays in treatment, increased risk of secondary fractures, and higher costs for the healthcare system.
The Red Star solution
Red Star FLS was introduced as a comprehensive solution to the challenges faced by NHS GG&C. The system offers the following features:
Automated Fracture Identification
Red Star FLS automates the identification of fractures, significantly reducing the risk of missed fractures and ensuring timely treatment initiation, reducing the time to identification from months to days and eliminating the backlog.
Integrated Audit Tool
Red Star FLS includes an integrated audit tool that allows NHS GG&C to monitor the system’s performance against national standards. This helps in continuous improvement and ensures compliance with regulatory requirements.
Efficiency Through Automation
The system replaces labour-intensive manual processes with automated ones, reducing the workload on staff, minimising errors, and increasing overall efficiency.
Modern Technology with Secure Cloud-Based Infrastructure
The outdated Microsoft Access database has been replaced with a secure, cloud-based infrastructure that supports FLS requests.
The introduction of Red Star FLS not only addressed the existing inefficiencies but also enhanced the overall quality of care for patients with fragility fractures.
Implementation Process
The implementation of Red Star FLS was a collaborative effort between Red Star and NHS GG&C. The process involved several key steps:
Stakeholder Engagement
Key stakeholders from both Red Star and NHS GG&C were involved from the outset to ensure that the system met the needs of all parties.
Technical Integration
The system was integrated with existing NHS systems to ensure a seamless transition.
Training
Staff were trained on how to use the system effectively, ensuring that they could take full advantage of its features.
Results
The implementation of Red Star FLS led to significant improvements in the management of fragility fractures within NHS GG&C:
| GGC FLS | RED STAR FLS |
|---|---|
| Backlog of 23,560 scans | No backlog |
| 24 months average time to non-hip identification fracture | All fractures identified and actioned within 72 hours |
| Delay or non-identification of vertebral fractures | Reduction in numbers of second fractures due to increased number of vertebral fractures being identified and started on treatment |
| No integrated audit tool | Fully automated integrated audit tool |
| Manual creation, printing and sending letters | Letters automatically generated |
| Outdated Microsoft Access database | Modern cloud-based technology platform |
| Manual identification of patients by nurses looking through spreadsheets of CHI numbers, checking each radiology report manually, reviewing medical history in the Clinical Portal and bone health data in GISMO, all of which takes 4.6 minutes per patient on average. | All the relevant targeted information is displayed on a single screen allowing dismissal of non-relevant reports in a few seconds. Average processing time for a patient is 2.1 minutes. |
Impact on NHS Greater Glasgow & Clyde
The broader impact of Red Star FLS on NHS GG&C has been substantial. The system has not only improved the efficiency of fracture care but also led to better patient outcomes and cost savings. The success of the system within NHS GG&C has paved the way for potential expansion to other NHS trusts across Scotland. The improved efficiency and patient care outcomes achieved with Red Star FLS highlight its potential to become a standard tool for managing fragility fractures across the NHS.
55%
reduction in case processing time
92%
increase in capacity
100%
reduction in waiting list
99.4%
reduction in time to create care plan
>6000
patients enrolled annually into FLS
Dr Maria Talla
Consultant Physician
Endocrinology & Mineral Metabolism Queen Elizabeth University Hospital Glasgow UK
“Red Star FLS has impacted every aspect of fragility fracture management at NHS GGC, drastically reducing delays in diagnosis and treatment. By automating processes, we’ve been able to do more with the same resources, significantly improving both efficiency and patient outcomes.”
“We needed a system that would modernise our working processes yet streamline the workload of Fracture Liaison Service. The RedStar system achieved this, and more.”
– Osteoporosis Nurse Specialist, Glasgow
“We now have a simplified yet efficient workflow that will greatly benefit service users and ensure the Osteoporosis Nurse Specialists working more effectively.”
– Osteoporosis Nurse Specialist, Glasgow
Conclusion
The collaboration between Red Star FLS and NHS Greater Glasgow and Clyde has been a success, with the implementation of the Red Star FLS system leading to significant improvements in fracture care. The system has proven to be a valuable tool in reducing inefficiencies, improving patient outcomes, and achieving cost savings. The success of this project demonstrates the importance of continued innovation in healthcare and the potential for wider adoption of Red Star FLS across the NHS.