Back off Specialists

Abstract

A New Spine Pathway 2016-2017 Advanced practice physiotherapy skills used prior to First Assessment Specialist referrals to orthopaedics Vision : accessibility, partnerships, excellent clinical outcomes, timely access. Previous model : Overloaded Orthopaedic services, fiscal restraints, unnecessary admissions/ tests, onsite underutilised expertise. Changes : Triage referrals. Orthopaedic specialists direct patients to Physiotherapist-led back clinic after paper triage only Data tracked. Educational tools Developed home program templates, back booklet, exercise sheets Integration and communication of pathways with other services Outcomes Keele STarT Back, VAS Target population : High needs communities, throughout Hawkes Bay Results : Reduced speicialist appointment/investigations: 87% avoided, 119 fewer MRIs 88 fewer spinal injections Accessible service : average interventions 3.4 Average wait time 41.6 days. 542 people offered assessment in first year Avoidable hospital admissions : trending down ( HRT data 2016) Client satisfaction high: 79% rate 10/10 Outcomes : at discharge 81% self managing well, minimal or no symptoms, 7% referred on to community support groups, 12% referred to FSA/specialist service Patient reported average Outcomes : Pain scores improved 23.9%, function 17.2%, self management improved 33.8% Sustainability : Further 0.5 equivalent advanced pracitioner employed mid 2016. data consistent over 18 months Enhancement of client services : more clinics opening in outlying community settings. Message for others : Expert Physiotherapists work with hospital specialists, staff, referrers, and community to ensure clients receive accessible appropriate expert care and back up. This service saves money, reduces diagnostic interventions, Orthopaedic Specialist time, while producing excellent outcomes. Treatment emphasising self-care, lifestyle change, supported by excellent educational tools, works for all stakeholders.