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Saturday, 16 November 2013
Learning Objective 1: After reviewing the poster, learners will understand how operationalizing the Rural Rheumatoid Arthritis Critical Pathway could improve provider management and patient outcomes.
Learning Objective 2: After reviewing the poster, the learner will verbalize two challenges surrounding rural rheumatoid arthritis patient’s access to care.
Rheumatoid Arthritis (RA) is a disease for which there is no cure. RA affects 1-2% of the general population and touches all ethnic groups, sexes, and age groups. The progressive nature of the disease coupled with patient care issues highly influence patient outcomes. Fifty-percent of patients have irreversible joint damage 2 years from the onset of symptoms. There has been a growing emphasis on diagnosing and treating RA early and intensively to secure positive patient outcomes. For rural Oklahoma providers and patients, the circumstances surrounding RA are truly unique. Rheumatology care providers are sparse, and wait times can vary from a few months to more than 1 year. 1.3 million Oklahomans face a health care provider shortage related to their rural setting; a (geographical) proximity to care deficit exists. Of primary care providers, one-third are not familiar or are uncomfortable with managing RA, so even if care is accessible, RA might not be addressed. A review of literature was completed for strategies addressing RA in the rural health care setting. No items were identified. Past positive outcomes associated with the implementation of critical pathways suggested a comprehensive pathway for RA would be beneficial. The purpose of this project was to develop and implement a RA critical pathway for rural health care providers to serve not only as an evidenced based plan of care until specialty care can be accessed, but to function as a comprehensive longitudinal care-tool, modeling care for the RA patient in the rural health setting. The primary capstone objective was to see improvement in at least one of the four established RA management categories. This pilot study was implemented at two rural clinics. Of items analyzed to help determine if the objective had been reached, five out of seven analyses provide confirmation the objective was achieved.