title: A framework for the development and implementation of an advanced practice role for physiotherapists that improves access and quality of care for patients.
abstract: A new model of care has been implemented at the Sunnybrook Holland Orthopaedic and Arthritic Centre that expands the role of physiotherapists to improve access and quality of care for patients requiring hip and knee replacement surgery. An advanced practice physiotherapist (APP) role was created to support both referral management and post-operative care to reduce surgeon workload and better streamline services. This article describes our nine-step framework for implementing an APP role and can be used as a template for other organizations evolving similar roles. The framework was adapted from the participatory, evidence-based, patient-focused process for the development of an advanced practice nurse role. Key steps include (1) obtaining stakeholder consensus, (2) identifying barriers and facilitators and (3) developing the necessary administrative and training supports as well as clinical protocols and an evaluation framework. Approaching change in a series of small steps (plan-do-study-act [PDSA] methodology) alongside existing processes has facilitated buy-in and role acceptance. The early and continued involvement of decision-makers within the organization has been paramount to successful implementation. In addition, patient input has been central to the evolution of the role, with patient satisfaction a key indicator. The new role and model of care reconfigures traditional roles and introduces a team approach that results in timely access to care for patients. Benefits include an improved assessment process, enhanced education across the care continuum and improved coordination and delivery of services.
authors: Holland Orthopaedic and Arthritic Centre of Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada. susan.robarts@sunnybrook.ca
authors: Susan
authors: S
authors: Robarts
authors: Deborah
authors: D
authors: Kennedy
authors: Anne Marie
authors: AM
authors: MacLeod
authors: Helen
authors: H
authors: Findlay
authors: Jeffrey
authors: J
authors: Gollish
mesh_terms: D017408:Guidelines as Topic; D006297:Health Services Accessibility; D006801:Humans; D017146:Models, Organizational; D009985:Orthopedics; D026761:Physical Therapy Specialty / Q000458:organization & administration*; D024382:Professional Role; D011787:Quality of Health Care