The American Academy of Orthopaedic Surgeons recommends that elderly patients who sustain a hip fracture should be evaluated and treated for osteoporosis. Despite research supporting the use of bisphosphonates for osteoporosis treatment and secondary fracture prevention in elderly patients, osteoporosis continues to be under-diagnosed and inadequately treated. Our quality improvement initiative aims to increase OHSU?s rate of successfully implementing bisphosphonate therapy by developing and implementing an inpatient protocol facilitating appropriate osteoporosis diagnosis and administration of a one-time intravenous bisphosphonate infusion for elderly patients admitted for hip fracture surgery.