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Podiatry triage at orthopaedic clinic

Discussion in 'Australia' started by NewsBot, Sep 12, 2012.

  1. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
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    Orthopaedic podiatry triage: process outcomes of a skill mix initiative
    Lyndon J. Homeming, Pim Kuipers and Aneel Nihal
    Australian Health Review Published online 10 September 2012
     
  2. Paul Bowles

    Paul Bowles Well-Known Member

    Here is a novel thought - get a Podiatric Surgeon as the consultant and do away with the other two !

    Just a thought - but it does kill two birds with one stone.
     
  3. phil

    phil Active Member

    How would that change the waiting list? They'd still have to wait just as long to see the Pod Surgeon. Unless every referal was immediately triaged by the consultant podiatric surgeon at the time of refferal. Do you not think a podiatrist would be the best person to recognise candidates for non-surgical treatment?
     
  4. Paul Bowles

    Paul Bowles Well-Known Member

    How wouldnt it change the waiting list? The Podiatric Surgeon could identify manageable pathology without surgery as well - triage is triage no matter who performs it, we are just deciding about who is best to provide appropriote/immediate triage which gives the best outcome to the patient in the most logical and economical fashion.

    A Podiatric Surgeon is a Podiatrist last time I checked......they could refer to the Podiatrist for orthomecahnical care, casting, diabetic assessment/management, minor surgery.
     
  5. phil

    phil Active Member

    Paul,

    Of course I know that a Podiatric surgeon is a Podiatrist. I think you've misunderstood me, or maybe i've misunderstood you.

    My point is that just by replacing a waiting list to see an Orthopaedic surgeon with a waiting list to see a Podiatric surgeon would make no difference to surgery waiting times. The critical change would be screening all referrals immediately as they are recieved. Unless you have a podiatrist (garden variety or surgeon) triaging AT REFERRAL, you'll make no difference on waiting lists.

    Who currently manages most orthopaedic waiting lists? For example, GP refers Mrs X to the local public hospital outpatient orthopaedic clinic with flat feet and ankle pain. Does Mrs X just go to the end of the list? The only model that I believe would reduce waiting time to surgery (for those who would have needed it) would be some sort of preliminary screening by a podiatrist, either before even being placed on a waiting list for surgical review, or while waiting on the list.

    On a side note (warning, cynicism ahead), my experience in public sector health is that the longer your waiting list, the more you can justify your existance and the more secure your funding it. Some of my colleuges made sure they always had a sizeable waiting list, no matter what!
     
  6. Tuckersm

    Tuckersm Well-Known Member

    Not in the new paradiam of public health.
    Hospitals are penalised for not meeting surgery wait list targets
    100% of urgent in 30 days, 80% of semi urgent in 90 days and 50% of routine in 12 months.

    similar targets are being proposed for out patients (in victoria), so triaging type clinics will increase, but it does have the flow on affect of increasing people on the surgical wait list.

    Funding will also change to improve patient flow through clinics, as the IHPA refines its funding formulas as clinical costing data improves.

    in Victoria physio led Hip and Knee clinics have been running for about 10 years
    http://www.health.vic.gov.au/oahks/ is a link to the programs evaluation.
     
  7. Paul Bowles

    Paul Bowles Well-Known Member

    Quit possibly apologies!

    [QUOTE}My point is that just by replacing a waiting list to see an Orthopaedic surgeon with a waiting list to see a Podiatric surgeon would make no difference to surgery waiting times. [/QUOTE]

    Agreed the point of different is at the triage - so a Pod Surgeon in the above study triaging them alone "could" be the point of difference. Didnt the Chiroprctors in Australia do this a few years back with a small pilot study with 1 chiro in a Sydney A and E? I need to dig that up.....
     
  8. rosherville

    rosherville Active Member

    Excuse my butting in but if a Podiatric Surgeon does some of the foot surgery it will free up some of the Orthopods surgery list and hence reduce waiting time for that list !

    After several years of the said Triage system I can`t say it was an improvement on the old GP to Consultant system. It resulted in many patients being told they didn`t need surgery but ending up having it a year or so later, enduring pain longer than necessary.
     
  9. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
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    FANCY FOOT WORK: THE INTRODUCTION ESP FOOT AND ANKLE CLINICS
    M. Maxwell, J. Davis, P. Loxdale, M. Giles and V. Kavanagh-Sharp
     
  10. NewsBot

    NewsBot The Admin that posts the news.

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  11. NewsBot

    NewsBot The Admin that posts the news.

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    Influence of Podiatry on Orthopedic Surgery at a Level I Trauma Center.
    Jakoi AM, Old AB, O'Neill CA, Stein BE, Stander EP, Rosenblatt J, Herman MJ.
    Orthopedics. 2014 Jun 1;37(6):e571-e575. doi: 10.3928/01477447-20140528-58.
     
  12. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
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    Evaluating the outcomes of a podiatry-led assessment service in a public hospital orthopaedic unit
    Daniel R Bonanno, Virginia G Medica, Daphne S Tan, Anita A Spring, Adam R Bird and Jana Gazarek
    Journal of Foot and Ankle Research 2014, 7:45 doi:10.1186/s13047-014-0045-6
     
  13. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
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    Influence of Podiatry on Orthopaedic Surgery at a Level I Trauma Center
    Andre Jakoi, MD, Philadelphia, PA
    Andrew B. Old, MD, Philadelphia, PA
    Craig A. O'Neill, MD, Perkasie, PA
    Martin J. Herman, MD, Philadelphia, PA
    Presented at AAOS Annual Meeting; March 2015
     
  14. NewsBot

    NewsBot The Admin that posts the news.

    Articles:
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    The integration of a Podiatrist into an orthopaedic department: a cost-consequences analysis
    Tom P. Walsh, Linda R. Ferris, Nancy C. Cullen, Christopher H. Brown, Cathy J. Loughry and Nikki M. McCaffrey
    Journal of Foot and Ankle Research201710:44
     
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