St. Joseph’s Health Care London (St. Joseph’s) is always striving to find new and better ways to care for patients. In a recent change in care delivery for shoulder patients, a model was developed to provide more timely access to physiotherapy for surgical patients. This change in practice ensures people who have shoulder care in hospital are taught post-operative exercises, activities, sleeping tips and are given necessary community referrals before discharge from day surgery.
“Before this process, there was a gap of five to 10 days to access outpatient physiotherapy,” says Lynn Stewart, coordinator, Roth|McFarlane Hand and Upper Limb Centre. “Now, after surgery or treatment, a physiotherapist assesses a patient the same day as their surgery.”
A win-win situation for the hospital and patients, early education on the day of surgery reduces the pressure to to book outpatient appointments which supports access for non-surgical cases and decreases wait times to see a physiotherapist. And, it is far more convenient for patients as it eliminates returning to the hospital for a physiotherapy appointment. “Our outpatient physio clinic sees over 750 patients each month. So it was important to ensure we are providing timely access,” states Lynn.
“The education piece is so important,” says John Syrovy, Roth|McFarlane physiotherapist. “Having the opportunity to discuss sling use, restrictions and home exercises is pivotal to minimize risk and improve patient recovery.”
There was plenty of discussion to ensure the right model was developed. “Because of the busy nature of the Surgical Day Care Unit (SDCU) we needed to ensure we didn’t impede patient flow. We needed an efficient process from admission to discharge,” states John.
Prior to June 2015, no shoulder patients were seen in the SDCU. By July 2016, the model of care change resulted in a 91 per cent increase to patients being seen after surgery, and those outcomes are still improving.
“The results have been fantastic,” says John, who rearranged his work hours to accommodate the patient load. “I continually hear how helpful this process is for patients and families.”
Since the new model has been implemented, the outpatient wait list for non-surgical shoulder patients has been eliminated and patients are going home fully educated in how to effectively care for their shoulders.
“We are so pleased with this practice,” says Lynn. “We will continue to look for ways to improve and enhance our care, but this was a big step in the right direction.”