title: Optimizing the interprofessional workforce for centralized intake of patients with osteoarthritis and rheumatoid disease: case study.
abstract: BACKGROUND
  This case study was part of a larger programme of research in Alberta that aims to develop an evidence-based model to optimize centralized intake province-wide to improve access to care. A centralized intake model places all referred patients on waiting lists based on severity and then directs them to the most appropriate provider or service. Our research focused on an in-depth assessment of two well-established models currently in place in Alberta to 1) enhance our understanding of the roles and responsibilities of staff in current intake processes, 2) identify workforce issues and opportunities within the current models, and 3) inform the potential use of alternative providers in the proposed centralized intake model.
  
  
  METHODS
  Our case study included two centralized intake models in Alberta associated with three clinics. One model involved one clinic that focuses on rheumatoid disease. The other model involved two clinics that focus on osteoarthritis. We completed a document review and interviews with managers and staff from both models. Finally, we reviewed the scope of practice regulations for a range of health-care providers to examine their suitability to contribute to the centralized intake process of osteoarthritis and rheumatoid disease.
  
  
  RESULTS
  Interview findings from both models suggested a need for an electronic medical record and eReferral system to improve the efficiency of the current process and reduce staff workload. Staff interviewed also spoke of the need to have a permanent musculoskeletal screener available to streamline the intake process for osteoarthritis patients. Both models relied on registered nurses, medical office assistants, and physicians throughout their intake process. Our scope of practice review revealed that several providers have the competencies to screen, assess, and provide case management at different junctures in the centralized intake of patients with osteoarthritis and rheumatoid disease.
  
  
  CONCLUSIONS
  Using a broader range of providers in the centralized intake of osteoarthritis and rheumatoid disease has the potential to improve access and care specifically related to the assessment and management of patients. This may enhance the patient care experience and address current access issues.
authors.affiliation: Workforce Research & Evaluation, Alberta Health Services, 10301 Southport Lane SW, T2W 1S7, Calgary, Alberta, Canada. esther.suter@albertahealthservices.ca.
authors.forename: Esther
authors.initials: E
authors.lastname: Suter
authors.affiliation: Workforce Research & Evaluation, Alberta Health Services, 10301 Southport Lane SW, T2W 1S7, Calgary, Alberta, Canada. arden.birney@albertahealthservices.ca.
authors.forename: Arden
authors.initials: A
authors.lastname: Birney
authors.affiliation: Workforce Research & Evaluation, Alberta Health Services, 10301 Southport Lane SW, T2W 1S7, Calgary, Alberta, Canada. paola.charland@albertahealthservices.ca.
authors.forename: Paola
authors.initials: P
authors.lastname: Charland
authors.affiliation: Workforce Research & Evaluation, Alberta Health Services, 2nd floor, Collin Barrows Building 3942 50A Avenue, PO Box 5030, T4N 6H2, Red Deer, Alberta, Canada. renee.misfeldt@albertahealthservices.ca.
authors.forename: Renee
authors.initials: R
authors.lastname: Misfeldt
authors.affiliation: Alberta Bone and Joint Health Institute, 400, 3280 Hospital Drive NW, T2N 4Z6, Calgary, Alberta, Canada. sweiss@albertaboneandjoint.com.
authors.forename: Stephen
authors.initials: S
authors.lastname: Weiss
authors.affiliation: Edmonton Musculoskeletal Centre, Suite 2068, 9499 137 Avenue NW, T5E 5R8, Edmonton, Alberta, Canada. jsquire@edmontonmsk.ca.
authors.forename: Jane Squire
authors.initials: JS
authors.lastname: Howden
authors.affiliation: The Alberta Hip and Knee Clinic, Gulf Canada Square, Suite 335, 401- 9th Avenue, SW, T2P 3C5, Calgary, Alberta, Canada. Jennifer.g.mcdougall@gmail.com.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hendricks
authors.affiliation: Division of Rheumatology, Alberta Health Services, Richmond Road Diagnostic & Treatment Centre, 1820 Richmond Road SW, T2T 5C7, Calgary, Alberta, Canada. theresa.lupton@albertahealthservices.ca.
authors.forename: Theresa
authors.initials: T
authors.lastname: Lupton
authors.affiliation: Alberta Bone and Joint Health Institute and Department of Community Health Sciences and Department of Medicine, Cumming School of Medicine, University of Calgary, TRW Building, 3rd Floor, 3280 Hospital Drive NW, T2N 4Z6, Calgary, Alberta, Canada. damarsha@ucalgary.ca.
authors.forename: Deborah
authors.initials: D
authors.lastname: Marshall
mesh_terms: D000416:Alberta; D000554:Ambulatory Care Facilities; D001172:Arthritis, Rheumatoid / Q000628:therapy; D057286:Electronic Health Records; D006282:Health Personnel; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D009726:Nurses; D010003:Osteoarthritis / Q000628:therapy; D010343:Patient Admission; D010820:Physicians; D011361:Professional Competence; D024382:Professional Role; D012017:Referral and Consultation; D012720:Severity of Illness Index; D014850:Waiting Lists; D014937:Work