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Physiotherapy Arthroplasty Review (PAR) Clinic

The Health Roundtable. New Zealand. Physiotherapy Arthroplasty Review (PAR) Clinic. 2 Future Role of Allied Health. Presenter: Jim Sayer Hospital Name: The Alfred Hospital Key Contact: Paula Harding P.Harding@alfred.org.au. Key Problem.

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Physiotherapy Arthroplasty Review (PAR) Clinic

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  1. The Health Roundtable New Zealand Physiotherapy Arthroplasty Review (PAR) Clinic 2 Future Role of Allied Health Presenter: Jim Sayer Hospital Name: The Alfred Hospital Key Contact: Paula Harding P.Harding@alfred.org.au

  2. Key Problem • Current orthopaedic post operative outpatient review clinic is not achieving organisation KPI’s • Demand for review appointments > number of appointments available • Only 41% of requests for 12 month post op reviews from Jan 08 – Jun 08 met the KPI. • KPI for priority 1 and 2 urgent NP appointments not being met 2008 – 09 • Evaluation of patient outcomes post surgery currently not possible • Documentation not consistent and often incomplete • Patient Outcome measures not used

  3. Key Strategies / Ideas Implemented Aim: • To improve the outpatient experience and outcomes for Orthopaedic patients • Optimise the current outpatient process by proposing the addition of an advanced Musculoskeletal Physiotherapist in the clinic Objectives: • To review the current orthopaedic post op review process • Identify opportunities within the orthopaedic post op caseload for service improvement

  4. Project Scoping Phase Scoping Phase: (March - Sep 2009) • Working party established with key people • The review process identified joint arthroplasty patients as most suitable patients to implement new model of care • Low infection and complication rate • Large amount of surgeon time required due to regular scheduling of reviews • New clinic proposed named Physiotherapy Arthroplasty Review Clinic (PAR) Clinic • Guidelines and framework of new model of care discussed with and final proposal presented to the Orthopaedic Surgeons • Support achieved from majority of surgeons

  5. PAR Clinic Flow Process

  6. Implementation Phase Implementation Phase (Oct 2009 +) • 10 patient reviews weekly • Appointment letter sent to patients advising them they will be seeing a physiotherapist. • Patient focused objective outcome measures, such as SF12 and Oxford hip and knee scale collected at each review • Just commenced ! • 27 patients so far • Excellent support from Orthopaedic Consultants • Excellent response from patients

  7. Lessons Learnt • Important to have that key stakeholder, the Director of Orthopaedics integrally involved • Pleasantly surprised by the level of support from the Orthopaedic Unit • Breaking the project up into Scoping and Implementation Phases • Ensured model and resources are well developed • Allowed time for Orthopedic Surgeons to adjust / consider/ input • Important to have support achieved from other key stakeholders: Outpatients, Radiology, IT • Inefficiencies with admin time required • Recruited help of AHA

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