A/Prof. Alana Jacob1,2, Miss Claire Hunt1, Mrs Lisa Beach1, Ms Sandra Gates1, Dr Caitlin Farmer1
1The Royal Melbourne Hospital, Melbourne, Australia, 2The University of Melbourne, Melbourne, Australia
Biography:
Alana Jacob is the Manager of Planned Surgery Reform at the Royal Melbourne Hospital. She has extensive previous experience managing acute and subacute inpatient and outpatient Allied Health teams and services across the public and private sector. Alana has a clinical background as a physiotherapist and has completed a Master of Business Administration majoring in health and human services management. Alana has a passion for improving patient outcomes by working with teams to improve systems and processes within the healthcare sector. Alana is an honorary Clinical Associate Professor in the Department of Physiotherapy at the University of Melbourne.
Abstract:
Background:
Growing demand for specialist surgical care, leading to expanding surgical waitlists is a well-recognised challenge nationally. Allied Health is well placed to deliver evidence based non-surgical models of care that alleviate this demand, however there is limited evidence on the feasibility and impact of rapid and diverse expansion of these models at a health service level.
Aim:
To investigate the effect of simultaneously implementing multiple allied health led non-surgical models of care on outpatient specialist surgical appointments and planned surgical waitlists.
Method:
We expanded six multidisciplinary non-surgical models of care all led by or including allied health professionals, including: physiotherapy, nutrition, podiatry, hand therapy, psychology, social work, pharmacy, nursing and medical specialists. These models of care provided comprehensive, timely assessment and treatment to manage patients' conditions and divert patients to conservative pathways where possible. Data was collected from the electronic medical record about new and review patient appointments in allied health, specialist clinic appointment diversion and removals from the surgical waitlist and descriptive statistics were utilised to analyse this data.
Results:
Over 18 months the multidisciplinary non-surgical clinics reviewed 3,011 new patients, removing 1,064 patients from the outpatient waiting list and 88 patients from the surgical waitlists. The two largest allied health led clinics diverted 95-98% of patients from surgical care to conservative management.
Conclusion:
Allied Health led non-surgical models of care support diversion of patients from specialist outpatient appointments and surgical waitlists, supporting timely access to appropriate treatment pathways and reducing demand for surgical care.