STOP the fracture SusQI Case Study

Claire Higham
Claire Higham • 6 March 2023

Resource Description: 

SusQI project completed as part of The Christie Green Team Competition from September to December 2022 by Ward 11 and the Endocrinology Unit

Team members:

  • Tom Hicklin: Ward Manager Ward 11
  • Claire Higham: Consultant Endocrinologist
  • Mohitraje Mankumare, IMT-2 Trainee

Significant help was also given by; Jo Woolley (Clinical audit and improvement manager)  and Angela Hayes (Clinical Nurse Specialist, Supportive and Palliative Care,Clinical Sustainability)

Project Aim:

Within the 10 week competition period to;

  • Assess fracture risk with FRAX in an unselected oncology inpatient population
  • Model and compare the environmental and economic impact of screening an oncology population with FRAX with that of sustaining a hip fracture


Thirteen (10 females, median age 62 yrs (range 39-77) patients were evaluated by FRAX score on the Acute Oncology ward.

Environmental impact: If extrapolated to 100 patients across a year, the environmental impact for screening equated to 129 kgCO2e. Modelling of the FRAX scores from the 13 patients suggested that this screening would prevent 1 hip fracture per 100 patients per year.

The Environmental impact of one hip fracture is 445.45 kgCO2e (likely an underestimate). Therefore a rough estimate of carbon savings at 316 kgCO2e for each 100 patients screened, equivalent to 911 miles driven in an average car.

Financial Impact: If extrapolated across a year, a minimum of £3,500 would be saved per 100 patients screened. Approximately 90,000 patients have a new patient appointment at the Christie each year.

Social impact: It is very distressing for patients, staff and the Trust to have patients that sustain fractures (particularly hip fracture) during oncology treatment. Prevention of this, or at least a programme for prevention could be beneficial on many levels.

You can read more about the project by downloading the attached case study.

Click here for more information on the Green Team Competition (including organisation impact reports)

Resource author(s)
Claire Higham: Consultant Endocrinologist
Resource publishing organisation(s) or journal
The Christie NHS Foundation Trust
Resource publication date
March 2023

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