Post-operative Orthopaedic Physiotherapy Review Clinics

Aim

To provide comprehensive, efficient, timely and equitable orthopaedic follow up services for clients following arthroplasty and hip-fracture surgery.

Benefits

• Comprehensive and client centred management for clients following uncomplicated post-arthroplasty or hip fracture surgery.
• Improved client access to timely, appropriate and safe care.
• Decreased surgeon outpatient load enabling increased availability for surgical or outpatient waitlist activity.

Background

Using primary contact physiotherapists to manage uncomplicated arthroplasty or hip fracture surgical outpatient follow-up has been identified as an effective model of care in public health services. The clinics contribute to reduced outpatient service burden and facilitate increased opportunity for surgeons to see new patients, potentially reducing outpatient waiting times.

Post-operative orthopaedic physiotherapy review clinics have been successfully implemented, including arthroplasty review clinics at Mater Hospital Brisbane, The Prince Charles Hospital and Mackay Base Hospital and a post-hip fracture review clinic at The Prince Charles Hospital. These clinics were developed with assistance and collaboration from practitioners in similar services within the Department of Health, Victoria.

Evaluation and results

Preliminary findings have shown:

• Improved patient access with low rates of rereferral to orthopaedic surgeons.
• No instances of missed ‘red flags’ (i.e. post discharge complications).
• High levels of client satisfaction, with improved continuity of care and reduced steps in the client journey.

Lessons learnt

• Executive and orthopaedic consultant support is critical for the implementation of a new model of care.
• Ongoing communication with stakeholders within the health services is important to support client and clinician understanding, acceptance, trust and uptake of a new model of care.
• Clearly defined referral processes and protocols are required to support decision making and promote clinical efficiency.