Implementation of a quality care management system for patients with arthritis of the hip and knee

Doerr, Christine R., Graves, Stephen E., Mercer, Graham E. and Osborne, Richard H. 2013, Implementation of a quality care management system for patients with arthritis of the hip and knee, Australian health review, vol. 37, no. 1, pp. 88-92, doi: 10.1071/AH11107.

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Title Implementation of a quality care management system for patients with arthritis of the hip and knee
Author(s) Doerr, Christine R.
Graves, Stephen E.
Mercer, Graham E.
Osborne, Richard H.
Journal name Australian health review
Volume number 37
Issue number 1
Start page 88
End page 92
Total pages 5
Publisher CSIRO Publishing
Place of publication Collingwood, Vic.
Publication date 2013
ISSN 0156-5788
Keyword(s) quality care management system
joint replacement
Summary The Orthopaedic Unit of the Repatriation General Hospital (RGH) in Adelaide, South Australia has implemented a quality care management system for patients with arthritis of the hip and knee. The system not only optimises conservative management but ensures that joint replacement surgery is undertaken in an appropriate and timely manner. This new service model addresses identified barriers to service access and provides a comprehensive, coordinated strategy for patient management. Over 4 years the model has reduced waiting times for initial outpatient assessment from 8 to 3 months and surgery from 18 to 8 months, while decreasing length of stay from 6.3 to 5.3 days for hips and 5.8 to 5.3 days for knees. The service reforms have been accompanied by positive feedback from patients and referring general practitioners in relation to the improved coordination of care and enhanced efficiency in service delivery.

What is known about the topic? Several important initiatives both overseas and within Australia have contributed significantly to the development of this model of care. These include the UK National Health Service ‘18 weeks’ Project, the Western Canada Waiting List Project, the New Zealand priority criteria project, the Queensland Health Orthopaedic Physiotherapy Screening Clinic, and most importantly the Melbourne Health–University of Melbourne Orthopaedic Waiting List Project where a wide range of models were explored across Victorian hospitals from 2005 and the Multi-Attribute Prioritisation Tool (MAPT) was developed, validated and tested. This project became the Osteoarthritis Hip and Knee Service (OAHKS) and was operationalised in the Victorian healthcare system from 2012. These initiatives examined and addressed various aspects of management systems for patients with arthritis of the hip and knee in their particular setting.

What does this paper add? The development of this system is an extension of what is already known and is the first to encompass a comprehensive and coordinated strategy across all stages of the care management pathway for this patient group. Their management extends from the initial referral to development and implementation of a management plan, including surgery if assessed as necessary and organisation of long-term post operative follow up as required. By detailing the elements, key processes and measurable outcomes of the service redesign this paper provides a model for other institutions to implement a similar initiative.

What are the implications for practitioners? An important aspect of the design process was practitioner acceptance and engagement and the ability to improve their capacity to deliver services within an efficient and effective model. Intrinsic to the model’s development was assessment of practitioner satisfaction. Data obtained including practitioner surveys indicated an increased level of both satisfaction with the redesigned management service, and confidence in it to deliver its intended improvements.
Language eng
DOI 10.1071/AH11107
Field of Research 111717 Primary Health Care
Socio Economic Objective 920205 Health Education and Promotion
HERDC Research category C1 Refereed article in a scholarly journal
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Document type: Journal Article
Collections: Faculty of Health
Population Health
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Created: Tue, 21 May 2013, 13:12:04 EST by Jane Moschetti

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