Abstract: The article focuses on a quality improvement initiative at the Veterans Administration Puget Sound Health Care System (VAPSHCS) that implemented registered nurse (RN) telephone follow-ups for managing bisphosphonate therapy in Veterans with osteoporosis. The study, conducted from May 2019 to November 2020, involved 45 Veterans and aimed to enhance medication adherence, reduce the need for physician visits, and address patient concerns effectively. Results indicated that 93% of patients received their medications, with 77% of alendronate users adhering correctly, while the intervention saved significant physician time and travel for patients. The findings suggest that RN-led follow-up could improve osteoporosis care delivery and patient outcomes among older Veterans.