Some hospitals in rural and remote regions have no access to either Specialist Orthopaedic or Advanced Practice Allied Health Professionals. Queen Elizabeth II Jubilee (QEII) Hospital and Mount Isa Hospital have worked collaboratively to develop a model of care to address this challenge for residents in North West Queensland.
QEII orthopaedic surgeons review the Mount Isa orthopaedic waitlist and categorise referrals into relevant streams. Patients are either allocated to the Physiotherapy Musculoskeletal Management Clinic (PMMC), Primary Contact Occupational Therapy Hands (PCOTH) or remain on the orthopaedic waitlist for medical review. Once allocated to either of the Allied Health (AH) streams, Advanced clinicians lead the consultation via telehealth from QEII. A local North West Hospital and Health Service (NWHHS) Physiotherapist or Occupational Therapist at Mount Isa Hospital is present with the patient, facilitating the physical assessment under the direct instruction of the Advanced clinician. Patients are provided early access to comprehensive assessment whilst remaining closer to home and reducing the burden of travel. Furthermore, this interaction enables a key learning environment for rural generalist allied health professionals to acquire additional skills that they can utilise within their regular practice, leaving a positive legacy on the NWHHS community.
For orthopaedic patients not suitable for these AH streams, QEII orthopaedic surgeons provide a telehealth model, seamlessly integrated into their department's usual outpatient clinics, inclusive of a broad range of subspecialists. For the minority of patients requiring surgery, patients receive treatment at QEII, one of Queensland's highest volume elective orthopaedic centres. When resources allow, QEII surgeons will travel to Mt Isa for minor procedure lists, ensuring North West patients are only required to leave their HHS when absolutely necessary.
This model of care ensures patients receive best-practice care, largely delivered in their remote location, with sustainable and reliability support from a major metropolitan orthopaedic centre.
This model provides a sustainable model of care for orthopaedic services which traditionally were highly vulnerable to service disruptions and fragmentation due to inherent workforce issues experienced in rural and remote settings. This innovative partnership addresses the inequity of access to these services for people of the North West in the short term, while building the local skills of allied health professionals to develop longer terms solutions. Furthermore, this innovative model has the additional long-term potential to upskill and mentor regional physiotherapists, providing another avenue to enable the sustainable recruitment of advanced-practice clinicians to regional facilities.
