Sammanfattning
Introduction: The measurement of bone mass density (BMD) is central to the diagnosis and treatment of osteoporosis. As part of a quality development project, we describe referrals to DXA (Dual X-ray Absorptiometry) scanning and the extent to which patients were scanned according to guidelines. Materials and methods: Clinical guidelines were developed by consensus among representatives of all relevant groups in the health care system in the County of Vestsjælland, Denmark. Criteria and standards were agreed. A special form was used for all referrals to the two departments carrying out DXA scans. This allowed for the collection of data at all steps in the process. Data were collected on all referrals between October 1, 2000, and September 30, 2002. Results: Of 1066 referral forms, 79% had a valid indication for scanning. In spite of the remaining 229 referral forms not including a valid indication, 225 of the patients were scanned. Of the referral forms with valid indications, only 59% contained all relevant information from the patient's history. Discussion: The project documented working processes through a complete registration of all referral and scanning procedures and revealed several problem areas that needed improvement. The study's design did not allow conclusions to be made as to whether the guidelines had helped doctors to limit their referrals to patients with a valid indication. The study revealed that the implementation of local guidelines was incomplete, and, among other things, did not lead to all DXA scans having a valid indication. It also pointed the way to improving the various steps of the overall process.