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Tuesday, November 3, 2009: 1:15 PM
Learning Objective 1: identify participants to be involved in a pre-operative assessment clinic for total joint replacement patients
Learning Objective 2: identify use of a model to facilitate patient care and expidite surgery for hip and knee replacement
OBJECTIVES: To improve and standardize access for patients requiring hip or knee total joint replacement (TJR). To reduce the wait time for patient referral from GP to orthopaedic surgeon. To improve the quality of life for patients with osteoarthritis by introducing a chronic disease management component of care for those patients not suitable for surgery. To increase the availability of time for orthopaedic surgeons to perform additional total joint replacements. DESCRIPTION: A collaborative approach between the disciplines of medicine, nursing and rehabilitation in caring for osteoarthritis patients, both surgical and non-surgical. The Advanced Practice Nurse is the manager of the clinic. Patients are assessed initially by either an Advanced Practice Nurse or Physiotherapist within two weeks of receiving a referral from a family physician. Patients who are surgical candidates see an orthopaedic surgeon within a month of the first assessment. This improves the conversion rate to surgery for orthopaedic surgeon clinic time. Non-surgical candidates, who previously had no support or recommendations available to them, are now streamed to a Chronic Disease Management program. This conservative management program has an education component composed of speakers (physiotherapist, occupational therapist, dietitian, and pharmacist) and an exercise component, which is a one on one physiotherapy appointment with an individualized prescribed exercise program. PRACTICAL APPLICATION: The clinic opened on October 1, 2007 and within the first year 600 patients had been assessed. Approximately 70% of patients see a surgeon and the others go to conservative management. Surgical wait times have decreased. Evaluation methods include patient satisfaction, measures of pain and disability, wait time data and demographic data. This clinic model, using health disciplines working together, could be used with other disciplines and management of other diseases.