Impact of the inter-professional team approach in the development of person-centered health care within an orthopaedic out-patient clinic

Abstract

Rationale, aims and objectives: High demand for orthopaedic specialist consultation has resulted in long waiting lists in public hospital out-patient clinics. This prospective study with a retrospective cohort analysis was conducted to evaluate the impact of a combined orthopaedic surgeon and physiotherapy triage clinic on waiting time and outcome of the initial consultation.Methods: Two hundred and thirty-nine patients were assessed in the triage clinic, while the reference group consisted of 136 patients from the same catchment who attended the same outpatient clinic in the previous year. Comparisons in waiting list time and initial clinic outcome were conducted and patient satisfaction with the triage clinic was assessed through a questionnaire.Results: Mean waiting time over the first 6 weeks of the triage clinic was 10 weeks compared to 4 weeks over the final 6 weeks (p<0.05, 95%CI:1.0 to 11.0). The mean waiting time for the triage clinic patients was 8 (SD=6) weeks, compared to 12 (SD=11) weeks for the control group patients (p<0.0001, 95%CI:2.5 to 6.0). Clinic outcomes were not significantly different between groups (p=0.43-0.92). About one-third of all patients seen in the triage clinic were referred for further consultation with an orthopaedic surgeon (triage 32%, control 36%). Patients reported high levels of satisfaction with the triage clinic.Conclusion: An inter-professional triage clinic model can significantly reduce orthopaedic outpatient clinic waiting times. Two-thirds of patients attending the clinic were managed without direct consultation with an orthopaedic surgeon. Patient support for the triage clinic was strong based on satisfaction survey responses.