Clinical Examination by Extended Scope Physiotherapists and Orthopaedic Surgeons in an Outpatient Shoulder Clinic: Agreement on Diagnosis and Treatment Plan and Evaluation of Costs and Organisation
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 69
- 试验地点
- 1
- 主要终点
- Treatment plan - physiotherapist
研究概览
简要总结
This study investigates the agreement between extended scope physiotherapists (ESP) and orthopaedic surgeons (OS) on diagnosis and treatment plan in an orthopaedic outpatient shoulder clinic. Furthermore a cost analysis and an evaluation of the interdisciplinary collaboration at the orthopaedic outpatient shoulder clinic (termed shoulder clinic in the following) will be performed.
详细描述
According to current practice, patients referred from a general practitioner (GP) to the Orthopaedic Outpatient Shoulder Clinic, Silkeborg Regional Hospital (SRH), Denmark, will be examined by either an orthopaedic surgeon (OS) or an extended scope physiotherapist (ESP), as these two groups of health professionals share this assignment. The decision on, which health professional is considered most appropriate to examine the patient, is done by a senior orthopaedic surgeon based on the available information in the referral letter from the GP. Three categories of appropriateness are used: most appropriate to be examined by an OS, most appropriate to be examined by an ESP and equally appropriate to be examined by an ESP or an OS.
The overall purpose of this study is to evaluate the quality of the shared assignment investigated through both professional and organisational outcomes. The following three subsidiary objectives are used:
- To estimate the agreement between ESP's and OS's on diagnosis and treatment plan (primary subsidiary objective)
- To estimate direct hospital costs of an examination performed by an ESP and an OS, respectively, and to estimate the difference in costs.
- To describe the interdisciplinary collaborative practice including evaluation of the extent of relational coordination.
Methods are described underneath related to each subsidiary objective.
- The study is conducted at the shoulder clinic, SRH. Eligibility criteria, intervention and outcomes are described elsewhere.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Cross Sectional
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Above the age of 18 years
- •Referred to The Shoulder Clinic at Silkeborg Regional Hospital
- •Considered equally appropriate to be examined by an ESP or an OS
- •Ability to read and understand Danish
排除标准
- 未提供
结局指标
主要结局
Treatment plan - physiotherapist
时间窗: Baseline
Treatment plan suggested by the ESP will be registered in a chart developed for the occasion. The chart has the same 5 pre-defined categories as for the OS: 1) referral to physiotherapy, 2) referral to diagnostic examination, 3) steroid injection, 4) surgery and 5) no intervention (categorical)
Treatment plan - orthopaedic surgeon
时间窗: Baseline
Treatment plan suggested by the OS will be registered in a chart developed for the occasion. The chart has 5 pre-defined categories: 1) referral to physiotherapy, 2) referral to diagnostic examination, 3) steroid injection, 4) surgery and 5) no intervention (categorical)
Treatment plan - common decision
时间窗: Baseline
The OS and ESP will discuss their results until they agree which treatment plan to offer the patient. Their decision will be registered in a chart developed for the occasion. The chart has the same 5 pre-defined categories as for the individual examinations: 1) referral to physiotherapy, 2) referral to diagnostic examination, 3) steroid injection, 4) surgery and 5) no intervention (categorical)
次要结局
- Diagnosis - orthopaedic surgeon(Baseline)
- Discussion needed - physiotherapist(Baseline)
- Diagnosis - common decision(Baseline)
- New appointment - orthopaedic surgeon(Baseline)
- Discussion needed - orthopaedic surgeon(Baseline)
- New appointment - physiotherapist(Baseline)
- Diagnosis - physiotherapist(Baseline)
- New appointment - common decision(Baseline)