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Musculoskeletal Rapid Access Clinics

For teams and individuals implementing musculoskeletal (MSK) centralized intake, assessment, and management models in Ontario in order to transform care for patients with MSK conditions. The purpose of this Community of Practice is support you in this work by compiling resources, sharing successes, and problem solving common challenges. Members will receive ongoing support from the initiative’s implementation teams.
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Danielle Petruccelli

Danielle Petruccelli

Hi Everyone, Within HNHB LHIN we have requests from patients regarding referral to surgeons who perform minimally invasive procedures, especially with respect to total hip. Likewise, we have had some surgeons who perform specific procedures promote to our APPs for discussion with the patient. I am wondering if other LHIN CI/RACs have dealt with this issue and developed an approach and/or algorithm for referral to support such requests.

1 week ago

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  • Maureen Sly-Havey

    Danielle

    In our LHIN, ultimately it is the patient who decides where they
    wish to go and who to see. If they wish to see a surgeon who performs a
    particular surgery, then they are given the wait times and if they wish to
    wait, they do. If they don’t wish to wait, they go to see someone else. I am
    not sure how to answer your other question...we know about all uni knees and
    hip resurfacing and total hip and knee...not sure what other type of surgery
    they are trying to “promote”...we have a list of who does what procedure,
    criteria for each of these procedures and we can send patients to these
    surgeons if they wish.

    Maureen1 week ago
  • Danielle PetruccelliThanks Maureen. Our APPs follow the same process that you have outlined. With respect to procedures not routinely performed by all surgeons (i.e. minimally invasive), do your APPs review those options with all patients as well, or do they only address upon patient request?1 week ago
  • Maureen Sly-HaveyWe usually address upon patient request. We can make some suggestions based on patient age, lifestyle, goals for post op etc. 1 week ago
Delaney Hines

Delaney HinesHello everyone, the recording of the Arthroscopic Knee Surgery: Aligning Practice with Clinical Evidence webinar held on October 24th from 7:00am to 8:30am led by Drs. Jim Waddell and Dr. Jeff Gollish is now posted in the attachments page. The link to the webinar recording is embedded in the file found under the Attachments tab. Attachments > Webinars >Arthroscopic Knee Surgery_ Aligning Practice with Clinical Evidence Webinar(October 24 2018). We've also attached the file here for your convenience!

3 weeks ago

Melaine Wistuba

Melaine Wistuba

Hi everyone,
I am wondering if a referral form and APP assessment form has already been shared for lower back (ISAEC)?

1 month ago

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  • Margaret FurmanHi Melanie, thank you for your question. The assessment form is provided as part of the LBP APP training. The referral form is provided to primary care providers once they complete the registration and on-boarding module. 1 month ago
  • Lesley WesleyIs it the same referral form that is online? 1 month ago
  • Margaret FurmanHi, on ISAEC.ORG you can find the patient intake form. 1 month ago
Melaine Wistuba

Melaine Wistuba

Hello everyone,

For those having medical directives or order sets for APP, what has been your rationale for choosing one over the other?

1 month ago

Rhonda Butler

Rhonda Butler

Hi everyone,
Just wanted to share a useful online learning site that was suggested to me by one of our Rheumatologists. They recommend it to their residents. It was developed with assistance from the arthritis society and the modules I've looked at were developed by one of our local Rheumatologists and an Advanced Practice ACPAC physiotherapist. Here's the link: https://rheumtalks.com/programs.php

1 month ago

Candace  Tse

Candace TseDear colleagues, 

Thank you very much for participating in the Advanced Practice Provider Competency Standard webinar hosted by Susan Robarts and Dr. Paula Harding on August 15, 2018. The recorded webinar is now available here:https://quorum.hqontario.ca/LinkClick.aspx?fileticket=B46z1AjV9II%3d&portalid=0

The Competency Standard and 2-part Workbook is a substantive resource for APPs meeting provincial role requirements for the Hip and Knee RACs. Along with the Orientation Manual, the Workbook is the starting point for APP training and is a guide to ongoing competency. 

Many of you have asked when the APP learning modules will be available. The learning modules are additional supports for self-directed learning and are under development by the ARTIC team. Module 1: Osteoarthritis is planned to be released in late fall 2018.

The development of the learning modules will NOT delay the training and competency assessment of APPs. The modules support self-directed learning and will be relevant for ongoing professional. As with all the materials put forward to date, a step-wise approach is undertaken in order to provide Ontario APPs with the best possible resources to support clinical practice. 


If you have any question, feel free to contact us at ARTIC@hqontario.ca

2 months ago

  • Alexandra HarrisonHello,
    Wondering any information exists related the number of patients an APP needs to see in order to build and/or maintain the competency standards? Thank you!5 days ago
Chantal Kangudie

Chantal Kangudie

Hi Margaret and Nitin, might the deck from the Champlain Lessons Learned webinar be available for review?
With thanks,
Chantal

2 months ago

Rhonda Butler

Rhonda Butler

Hi - I'm coming a bit later to this process than many of the other LHINs and sites so hoping to learn from your experience.  I've found a number of online diagnostic imaging for PTs education options - was wondering if anyone has any experience with any of these, and how are you addressing education for this area in the interest of developing medical directives at your site. 

2 months ago

Maureen Sly-Havey

Maureen Sly-Havey

I am wondering if anyone has a same day discharge for hip/knee replacement patients? I am looking for information specific to anaesthesia/pain management used; physiotherapy seeing patients in day stay unit prior to discharge; and criteria in choosing patients for same day discharge. Thanks!

2 months ago

  • Allison DrynanSome of the Mount Sinai Hospital surgeons are operating at Women's College Hospital, where they are performing same day discharges.  You might try connecting with Physiotherapist Gillian Grant,  Gillian.Grant@wchospital.ca.2 months ago
Delaney Hines

Delaney HinesHello everyone, the recording of the APP Competency Framework Orientation webinar held on August 15th from 5pm to 6:30pm led by Susan Robarts and Dr. Paula Harding from Australia is now posted in the attachments page. The link to the webinar recording is embedded in the file found under the Attachments tab. Attachments > Webinars > APP Competency Standard Webinar_with Paula Harding and Susan Robarts (August 15 2018). We've also attached the file here for your convenience!

2 months ago

Candace  Tse

Candace Tse

Hi everyone, this is a reminder that the ARTIC team will be hosting a Competency Framework Orientation webinar on August 15th from 5pm to 6:30pm. Susan Robarts and Dr. Paula Harding from Australia will discuss how the workbook can be successfully implemented in clinical settings. Please share this learning opportunity with the following target audiences in your LHIN. 

Target audiences of the webinar:
1) Frontline teams: Site surgeon leads, current and incoming advanced practice providers, practice leads and clinical managers
2) LHIN leads or program leads that need to be aware of the competency standards as they pertain to clinical governance/risk management.


NOTE: We recommend that APPs complete the Learning Needs Analysis in Part 1 prior to the webinar.
The Workbook applies to the Hip and Knee Arthritis Rapid Access Clinic specifically; however, the competency framework is applicable to the MSK advanced practice role. Additional workbooks can be adapted/developed for other practice contexts. 

3 months ago

Candace  Tse

Candace TseThe Advanced Practice Provider Competency Workbook Part 1 and 2 are now available. The letter introducing the Competency Workbook provides information on target audiences and how to use the workbook. Please read through the introduction letter before you take a deeper dive into the Competency Workbook. 

To assist with applying the competency standards: 
 1.
Please share the APP
Competency Workbooks with the APPs and relevant clinical teams in your LHIN. 
 2.
A webinar will be held on August 15th, 5:00 -
6:30 PM with the original developer, Dr.
Paula Harding and Susan Robarts (details to follow). 
 3.
We recommend that APPs
complete the Learning Needs Analysis in
Part 1 prior to the webinar and review the publication describing the
development of the Clinical Education Framework and Competency Standards
available at the link below.


Harding Paula, Prescott Jonathan, Sayer James, Pearce Andrea (2015). Advanced musculoskeletal physiotherapy clinical education framework supporting an emerging new workforce. Australian Health Review 39, 271-282. http://doi.org/10.1071/AH14208

The ARTIC MSK team will continue to update and review tools, resources and educational materials to enable the best system for patients and clinicians, and broader adoption and applicability of materials to additional MSK conditions. 

Please email us at ARTIC@hqontario.ca if you have questions. 

4 months ago

  • Rhonda ButlerHi everyone.  Just wanted to leave my "plug" for these workbooks and orientation manual.  They can look a bit intimidating at the onset with so many pages but I find myself referring to them frequently as a framework to design and structure our program, as well as to aid in my competency development.  Hope you all find them just as useful - really happy to have this resource!1 month ago
Delaney Hines

Delaney HinesThe Low Back Pain (ISAEC) Practice Leader webinar held on June 28th, 2018 is now posted. The link to the webinar recording is embedded in the file found under the Attachments tab. Attachments > Webinars > Low Back Pain (ISAEC) Practice Leader Webinar(June 28 2018). We've also attached the file here for your convenience!

4 months ago

Chantal Kangudie

Chantal Kangudie

Hello,
Recently, there was some discussion regarding the sharing of a template that one of the LHINs used to gather/collate/list their Community Programs and Resources. Has this become available or is someone open to sharing what they used when pulling together their Community Programs and Resources?
Kind regards,
Chantal

5 months ago

Candace  Tse

Candace TseTeams that are piloting the bundled hip and knee replacement QBP program have raised questions related to Patient Reported Outcome Measures (PROMs), especially around data collection points from patients. With permission, I am sharing a presentation slidedeck and a FAQ document. They provide some useful information and a very nice schematic that outlines the the data collection points along the patient journey. If you have further questions regarding the bundled care project, please forward your questions to bundledcare@ontario.ca

5 months ago

Chantal Kangudie

Chantal Kangudie

Hi there,
Will the PCP Engagement Webinar deck from yesterday be uploaded here? It was a great session and some of the information would be helpful to use.
Alternatively, being able to still access the webinar itself would also work.
Kind regards,
Chantal

5 months ago

Margaret Furman

Margaret FurmanAttached below please find the outline of the ISAEC PCP On-boarding and Registration Module. The module was created to familiarize PCPs with both the ISAEC Model of Care and the ISAEC Referral Process. Once the module is completed it will provide PCPs with the knowledge to seamlessly refer qualified patients to The RAC for LBP (ISAEC) pathway. A demonstration video of the online module will be shared with the LHIN implementation teams shortly. The LHINs will then reach out to primary care providers in their regions and provide registration and on-boarding details as part the regional implementation. This document is also posted in the attachments section: Attachments > Tools and Templates > ISAEC > ISAEC Training.

5 months ago

Candace  Tse

Candace TseSusan Robarts, Provincial Clinical Implementation Lead, and Dr. Jeff Gollish, Provincial Lead, are pleased to share the Advanced Practice Provider Orientation Manual. This manual supports onboarding and training of new Advanced Practice Providers (APPs) working in hip and knee arthritis Rapid Access Clinics. The content is based on APP orientation and training processes developed at Sunnybrook Health Sciences Centre and incorporates lessons learned from similar successful MSK models of care from across the province as well as international jurisdictions. 
Please note that The Advanced Practice Provider Orientation Manual is intended to be a resource for clinicians supporting the APP orientation and training. The key components of the APP training program outlined in this manual include: 3-month practice development program and timeline, roles and responsibilities, as well as checklists and other tools to support learning. This manual should be read in conjunction with the soon-to-be released APP competency workbook(updates regarding the release of the APP competency workbook will follow shortly). Please share this manual with the APPs and relevant clinical teams in your LHIN at your earliest convenience. 
A French version of this document will be available soon. Support for navigating the APP training resources will be scheduled for June

5 months ago

Margaret Furman

Margaret FurmanThe updated ISAEC APP and PL Training Outlines are now posted in the attachments section. Attachments > Tools and Templates > ISAEC > ISAEC Training. These two documents replace the previously posted document titled: "ISAEC PL & APP Complete Training Outline". The updated documents, provided by the ISAEC Ops Team (Health Quality Programs- UHN), include further detail for the PL training. Please see attachment below for your convenience.

6 months ago

Margaret Furman

Margaret FurmanRole description for the Site Surgeon Sponsor for RAC for Low Back Pain (ISAEC) is now posted in the attachments section. Attachments > Tools and Templates > ISAEC. Please see attachment below for your convenience.

6 months ago