Abstract
Background: Osteoporosis and fragility fractures impose a major burden on older New Zealanders and the healthcare system. This report describes a national quality improvement programme for secondary fracture prevention. Fracture Liaison Services (FLS) are internationally recognised as the optimal model of care for secondary fracture prevention. A 2021 national survey identified marked variation in service organisation across New Zealand, prompting development of national clinical standards, key performance indicators (KPIs), and a registry to support benchmarking and quality improvement.
Results: From mid-2022 to mid-2024, the registry documented care of more than 26,600 fragility fracture patients. Local dashboards provide FLS teams with performance feedback against KPIs, while a “Refracture tracker” alerts teams to secondary fractures and provides a national measure of FLS effectiveness.
Conclusions: The combination of registry-based feedback, standardised FLS Quality Improvement Plans using Plan-Do-Study-Act cycles, and a national FLS network supporting shared learning positions New Zealand to achieve universal access to International Osteoporosis Foundation-accredited FLS in 2026.