Niigata Prefectural Tokamachi Hospital

To reduce the burden of consultation, a dedicated internist ensured coordination between the orthopedic surgeon and each medical specialty. As recommended by several hip fracture management guidelines, the goal was early surgery, within 48 h after surgery, with specialists providing their input on the patient's status for early surgery. The anesthesiologist arranged for surgery to be performed as soon as possible, once a patient’s condition was confirmed to be suitable for surgery. Within our FLS, the pharmacist was responsible to evaluate a patient’s osteoporosis treatment status prior to the injury and to inform the nurse on the unit and treating orthopedic surgeon if osteoporosis medications should be prescribed before discharge to prevent secondary fracture. The treating orthopedic surgeon prescribed the appropriate anti-osteoporosis treatment, such as bisphosphonate, according to the pharmacist’s recommendation.

The physical therapist was responsible for post-operative rehabilitation, including gait training and return to independence in activities of daily living. A home visit was also performed by the physical therapist prior to discharge to verify a patient’s living environment and to recommend adaptations as needed. The nurses on the unit liaised with the pharmacist and physical therapist to provide patient support for discharge. Lastly, before discharge, the dentist on the FLS team verified a patient’s oral condition for the prevention of osteonecrosis of the jaw.