Dr Carol McCrum1, Ms Felicity Martin1
1Canberra Health Services, Canberra, Australia
Biography:
Dr Carol McCrum is an advanced Practice physiotherapist in Rheumatology at Canberra health Services and keen to support Australian healthcare utilisation of allied health expertise and advanced practice capabilities.
Abstract:
Introduction:
Some conditions are challenging to identify without specialty knowledge. There are many conditions where specialist Allied Health expertise can be utilised. Case-finding screening approaches can help suspect and identify conditions that may need an alternative healthcare pathway and can support more timely intervention.
Purpose:
This project outlines an Advanced Practice (AP) physiotherapy-led case-finding strategy for screening the Spinal waitlist and facilitating fast-track assessment.
Methods:
A screening questionnaire combined risk factor screening and musculoskeletal differentiation questions to support suspicion and referral decisions for possible inflammatory arthritis. Responses suspicious for axial spondyloarthritis were invited for fast-track assessment and suspected cases referred to rheumatology.
Results:
Since project implementation, 24/30 screening questionnaire responses have been received. Six (6) onward referrals have been made to Rheumatology following fast-tracked clinic assessments. Five of six (5/6) onward referrals received an inflammatory disease diagnosis.
Conclusion(s):
An Advanced Practice allied health case-finding approach using specialty expertise has supported timely and cost-effective identification of axial spondyloarthritis for people waiting on other specialty waitlists. Physiotherapy-led case-finding enabled earlier diagnosis, multispecialty service safety and quality improvements, and supported avoidance of potentially harmful and inappropriate waiting list time.
Implications:
Allied Health specialty expertise and targeted screening strategies can support timely right pathway/right care for people with conditions commonly unrecognised and inappropriately referred to other specialties or on waitlists for medical consultations who may be safely and effectively helped by allied health expertise in the interim.