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1.
Arthritis Res Ther ; 17: 322, 2015 Nov 14.
Article in English | MEDLINE | ID: mdl-26568556

ABSTRACT

INTRODUCTION: Centralized intake is integral to healthcare systems to support timely access to appropriate health services. The aim of this study was to develop key performance indicators (KPIs) to evaluate centralized intake systems for patients with osteoarthritis (OA) and rheumatoid arthritis (RA). METHODS: Phase 1 involved stakeholder meetings including healthcare providers, managers, researchers and patients to obtain input on candidate KPIs, aligned along six quality dimensions: appropriateness, accessibility, acceptability, efficiency, effectiveness, and safety. Phase 2 involved literature reviews to ensure KPIs were based on best practices and harmonized with existing measures. Phase 3 involved a three-round, online modified Delphi panel to finalize the KPIs. The panel consisted of two rounds of rating and a round of online and in-person discussions. KPIs rated as valid and important (≥7 on a 9-point Likert scale) were included in the final set. RESULTS: Twenty-five KPIs identified and substantiated during Phases 1 and 2 were submitted to 27 panellists including healthcare providers, managers, researchers, and patients in Phase 3. After the in-person meeting, three KPIs were removed and six were suggested. The final set includes 9 OA KPIs, 10 RA KPIs and 9 relating to centralized intake processes for both conditions. All 28 KPIs were rated as valid and important. CONCLUSIONS: Arthritis stakeholders have proposed 28 KPIs that should be used in quality improvement efforts when evaluating centralized intake for OA and RA. The KPIs measure five of the six dimensions of quality and are relevant to patients, practitioners and health systems.


Subject(s)
Arthritis, Rheumatoid/therapy , Delphi Technique , Osteoarthritis/therapy , Patient Satisfaction , Quality Indicators, Health Care/standards , Alberta/epidemiology , Arthritis, Rheumatoid/epidemiology , Health Personnel/standards , Health Services Accessibility/standards , Humans , Osteoarthritis/epidemiology
2.
Hum Resour Health ; 13: 41, 2015 May 28.
Article in English | MEDLINE | ID: mdl-26016670

ABSTRACT

INTRODUCTION: This case study was part of a larger programme of research in Alberta that aims to develop an evidence-based model to optimize centralized intake province-wide to improve access to care. A centralized intake model places all referred patients on waiting lists based on severity and then directs them to the most appropriate provider or service. Our research focused on an in-depth assessment of two well-established models currently in place in Alberta to 1) enhance our understanding of the roles and responsibilities of staff in current intake processes, 2) identify workforce issues and opportunities within the current models, and 3) inform the potential use of alternative providers in the proposed centralized intake model. CASE DESCRIPTION: Our case study included two centralized intake models in Alberta associated with three clinics. One model involved one clinic that focuses on rheumatoid disease. The other model involved two clinics that focus on osteoarthritis. We completed a document review and interviews with managers and staff from both models. Finally, we reviewed the scope of practice regulations for a range of health-care providers to examine their suitability to contribute to the centralized intake process of osteoarthritis and rheumatoid disease. DISCUSSION AND EVALUATION: Interview findings from both models suggested a need for an electronic medical record and eReferral system to improve the efficiency of the current process and reduce staff workload. Staff interviewed also spoke of the need to have a permanent musculoskeletal screener available to streamline the intake process for osteoarthritis patients. Both models relied on registered nurses, medical office assistants, and physicians throughout their intake process. Our scope of practice review revealed that several providers have the competencies to screen, assess, and provide case management at different junctures in the centralized intake of patients with osteoarthritis and rheumatoid disease. CONCLUSIONS: Using a broader range of providers in the centralized intake of osteoarthritis and rheumatoid disease has the potential to improve access and care specifically related to the assessment and management of patients. This may enhance the patient care experience and address current access issues.


Subject(s)
Arthritis, Rheumatoid , Health Personnel , Health Services Accessibility , Osteoarthritis , Patient Admission , Professional Competence , Professional Role , Alberta , Ambulatory Care Facilities , Arthritis, Rheumatoid/therapy , Electronic Health Records , Health Services Needs and Demand , Humans , Nurses , Osteoarthritis/therapy , Physicians , Referral and Consultation , Severity of Illness Index , Waiting Lists , Work
3.
Healthc Manage Forum ; 27(1): 15-9, 2014.
Article in English | MEDLINE | ID: mdl-25109132

ABSTRACT

Performance management tools commonly used in business, such as incentives and the balanced scorecard, can be effectively applied in the public healthcare sector to improve quality of care. The province of Alberta applied these tools with the Institute for Health Improvement Learning Collaborative method to accelerate adoption of a clinical care pathway for hip and knee replacements. The results showed measurable improvements in all quality dimensions, including shorter hospital stays and wait times, higher bed utilization, earlier patient ambulation, and better patient outcomes.


Subject(s)
Benchmarking , Health Facilities , Motivation , Total Quality Management/methods , Alberta , Canada , Humans , Institutional Management Teams
4.
Healthc Q ; 15(3): 37-42, 2012.
Article in English | MEDLINE | ID: mdl-22986564

ABSTRACT

Despite various health system improvements across Alberta, the wait times benchmark was not being met for all patients requiring hip or knee arthroplasty. Alberta Health Services Bone and Joint Clinical Network working groups, in collaboration with other provincial organizations, gained consensus on the development and implementation of a set of provincial Wait Times Rules. These rules standardize the definition and measurement of data elements specific to joint replacement and distinguish between voluntary (patient-related) versus involuntary (healthcare system-related) wait times. Collectively, this information will help identify trends in wait times and more accurately show where wait times can be reduced.


Subject(s)
Arthroplasty, Replacement, Hip , Arthroplasty, Replacement, Knee , Health Care Rationing/standards , Regional Health Planning/standards , Waiting Lists , Alberta , Benchmarking/methods , Consensus , Data Collection/methods , Health Care Rationing/statistics & numerical data , Humans , Reference Standards , Regional Health Planning/statistics & numerical data
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