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APCO Bone Health QI Tool Kit

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APCO Bone Health QI Tool Kit

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The APCO Bone Health QI Tool Kit aims to address the major public health burden of osteoporosis throughout the Asia Pacific (AP) region through the promotion of quality improvement (QI) of osteoporosis care.

Currently one-in-four patients who sustain a hip fracture die within a year, and less than half of those who survive, regain their previous level of function. By 2050, one in four people in the AP will be aged over 60 years. This portion of the population is expected to triple between 2010 and 2050, reaching close to 1.3 billion people. Within the same timeframe, between 4.5 to 6.3 million hip fractures are predicted to occur worldwide, half of which will occur in Asia.


The tool kit is designed to help healthcare providers (HCPs) stem this current healthcare crisis through a process of working together, to achieve shared goals. It focuses on closing this care gap by:

  • Understanding the baseline variables and current state of osteoporosis care in any given institution or health care practice.
  • Enabling benchmarking clinical practice against The APCO Framework, evidence-based clinical practice guidelines or established protocols for the chosen standard of care.
  • Using the findings to then improve the quality of care through iterative PDSA cycles.
  • Using the lessons learned from implementation of the APCO Clinical Standard at an institutional level, to build momentum, and work towards inclusion of the quality improvement/clinical standard in national guidelines, and lobbying for funding and policy change, as appropriate.

The tool kit is based on seven selected standards from The APCO Framework that are applicable to the clinical setting. Implementation of the QI will be through Plan-Do-Study-Act (PDSA) cycles – a quality improvement strategy that tests a change on a small scale. The PDSA builds on the learning from these test cycles in a structured way before implementation on a wider scale.

The PDSA cycles are iterative. Each cycle involves the following four stages:

1. Plan – developing a plan to test the change;

2. Do – carrying out the test;

3. Study – observing and learning; and

4. Act – planning the next change cycle or full implementation.


Articulating the benefits of the APCO Bone Health and QI Tool Kit activity can help promote engagement and cooperation. Having a supportive organisational culture, good design and planning, and follow through on results to ensure the data collection is meaningful and achievable, will prove critical to success.

Data collected through the audit should be used to benchmark practice against the standards recommended by The APCO Framework, to demonstrate to stakeholders that the audit was worth the effort, and that it contributed to tangible change.

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  • Access the APCO Bone Health QI Tool Kit

    Thank you for visiting the APCO website and requesting to download the APCO Bone Health QI Tool Kit.

    Please complete the following short form to request access to the tool kit. Once you have submitted the form, the APCO Secretariat will verify your details and will send you a downloadable link to the APCO Bone Health QI Tool Kit.

  • The information provided by APCO, including but not limited to the APCO Framework, the APCO Healthcare Practitioner Educational Slides, and the APCO QI Toolkit (collectively, the “APCO Materials”), are intended for qualified medical doctors and provided solely for information purposes only. The information provided does not constitute medical advice and shall not operate in any way to substitute, replace or affect any proper medical advice, diagnosis, analysis, testing, and treatment provided by qualified medical doctors. APCO assume no responsibility for any circumstances arising out of or in connection with the use, misuse, interpretation or application of any information contained in the APCO Materials.

    APCO exclude all implied conditions, warranties, representations or other terms which may apply to the APCO Materials, APCO’s website, any content of APCO’s website and any documents or information made available on APCO’s website. APCO will not be liable for any loss or damage, whether in contract, tort (including negligence), breach of statutory duty, or otherwise, even if it is foreseeable, arising out of or in connection with the use or the inability to use APCO’s website, use of or reliance on any content on APCO’s website or any documents or information (including the APCO Materials) made available on APCO’s website. In particular, APCO will not be liable under any circumstances for (i) loss of profits, sales, business, or revenue; (ii) business interruption; (iii) loss of anticipated savings; (iv) loss of business opportunity, goodwill or reputation; or (v) any indirect or consequential loss or damage.
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The security of your personal information is important to us. We follow generally accepted industry standards to protect the personal information submitted to us, both during transmission, and once received.

Should you wish to remove your details at any time from our system, please email us at secretariat@apcobonehealth.org. Our full privacy policy is available on our website.

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Channel News Asia (CNA) interview with APCO Chair, Dr Manju Chandran, reflecting on the launch of the APCO Bone Health QI Tool Kit

Listen below to Dr Manju Chandran’s radio interview with Channel News Asia (CNA) 938 Health Matters host, Daniel Martin, on May 31, 2022.To read the corresponding radio transcript, click on the pdf here.

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