Regional Rheumatology Strategy: Facilitating Patient Access to Multidisciplinary Care
Chronic Care and Patient-Centred Care
Transformation: Health care is being delivered in a team model rather than as individual experts working separately. This fosters collaborations between primary care, specialists, nurses, physiotherapists and occupational therapists. Adoptability: Use of telecommunication and electronic communication make this model highly adaptable to different institutions. Outcomes: Improved quality of patient care and reduced patient burden of frequently travelling to a tertiary care centre.
Background: Southwestern Ontario is under-serviced for rheumatology and arthritis is a common cause of morbidity. Improving rheumatology knowledge and skills of Nurse Practitioners (NP) in our region and utilizing telemedicine for our patient education will create a better model for chronic disease management.
Methods: The project included two phases. Phase I included a needs assessment to determine the educational needs of NPs in primary care and provided knowledge in Rheumatology. Phase II included clinical skills training. We partnered with NPs in the Grey-Bruce area to pilot a continuing education package. Phase I. A curriculum for NPs was created. Participants completed feedback and pre-post disease management knowledge scores. Phase II. The second phase was directed at enhancing the skills of Phase I completers. This phase included a centralized preceptorship program and clinical internships at our center to prepare NPs to co-manage patients with rheumatic diseases.
Results: A curriculum was disseminated to a multidisciplinary care teem. Seventeen webcasts were delivered. Pre- and post-program knowledge assessments were completed. Participating NPs also performed pre- and post-program chart reviews. We developed an Annual Rheumatology Update Day. Nurse practitioners from within our referral area participated in local preceptorships. A rheumatologist and psychologist travelled to Chatham to give didactic lectures and develop a plan to facilitate patient care.
Conclusions: The project was presented at two international conferences.
Future: We proposed further collaboration with the Owen Sound and Goderich sites. Both sites were interested in linking to St. Joseph’s rheumatology via the telehealth network.