title: System integration and clinical utilization of the Advanced Clinician Practitioner in Arthritis Care (ACPAC) Program-Trained Extended Role Practitioners in Ontario: a two-year, system-level evaluation.
abstract: BACKGROUND
  The Advanced Clinician Practitioner in Arthritis Care (ACPAC) program was developed in 2005 to prepare experienced physical and occupational therapists to function as extended role practitioners (ERPs) within models of arthritis care across Ontario, Canada.
  
  
  OBJECTIVE
  To examine the system-level integration and clinical utilization of the ACPAC program-trained ERP.
  
  
  METHODS
  A longitudinal survey was administered to all ACPAC graduates over a two-year period (n=30).
  
  
  RESULTS
  The majority of ERPs were physical therapists working in urban settings. Family physicians or physician specialists referred the majority of patients. The longest median wait time to access ERPs' services was 22 days. Half of the ERPs triaged patients, and most of those who did triage (75%) worked under medical directives. Approximately half (51.6%) of the patients seen had a diagnosis of osteoarthritis, followed by rheumatoid arthritis (14.7%).
  
  
  CONCLUSIONS
  Understanding the system-level impact of this unique human resource can help to shape healthcare planning and delivery of care.
authors: Physiotherapist Practitioner, Toronto Western Hospital, Lecturer, Department of Physical Therapy, University of Toronto, Toronto, ON.
authors: Laura A
authors: LA
authors: Passalent
authors: Carol
authors: C
authors: Kennedy
authors: Kelly
authors: K
authors: Warmington
authors: Leslie J
authors: LJ
authors: Soever
authors: Katie
authors: K
authors: Lundon
authors: Rachel
authors: R
authors: Shupak
authors: Sydney
authors: S
authors: Lineker
authors: Rayfel
authors: R
authors: Schneider
mesh_terms: D001168:Arthritis / Q000175:diagnosis / Q000628:therapy*; D003695:Delivery of Health Care / Q000379:methods* / Q000458:organization & administration / Q000592:standards; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000458:organization & administration / Q000706:statistics & numerical data; D006801:Humans; D009788:Occupational Therapy / Q000458:organization & administration*; D009864:Ontario; D059825:Physical Therapists / Q000458:organization & administration*; D024382:Professional Role; D015397:Program Evaluation; D012017:Referral and Consultation / Q000706:statistics & numerical data; D014850:Waiting Lists
references: J Rheumatol. 2004 Feb;31(2):390-2
references: 14760812
references: J Rheumatol. 2011 Jul;38(7):1282-8
references: 21572157
references: J Interprof Care. 2009 Mar;23(2):198-200
references: 19085269
references: Physiother Can. 2011 Winter;63(1):94-103
references: 22210986
references: Healthc Q. 2008;11(3):62-8
references: 18536536
references: Physiother Can. 2013 Winter;65(1):46-55
references: 24381382
references: BMC Musculoskelet Disord. 2012 Jun 21;13:107
references: 22716771