Transcript - Osteoarthritis chronic care program RNS video

​Osteoarthritis - patients and clinicians - Royal North Shore Hospital

Matthew Williams, Physiotherapist, OACCP Program:   My main role as a physiotherapist is to educate patients. First of all, when I see them, they're confused and they're scared. My job is really just to break things down, explain exactly what osteoarthritis is. The results that we see on their scans are very normal and exercise actually makes them more robust and enables the body to respond, the muscles strengthen, the joints lubricate so it's instilling that confidence and setting them up with a program. By the end of the program we're hoping they're meeting their goals which is an overseas trip, playing with the grandkids or whatever it is that's really important to them.

Zala Pickett, Patient:  My doctor told me that I'd maybe torn a meniscus. I'd seen a knee specialist in the city and he had said there's nothing that can be done, we've got to cut it out. I think I went seeking a second opinion and found myself here at the North Shore Hospital. So almost immediately doing the exercises that Matt set out for me and beginning to reduce my weight, I immediately felt better about my levels of pain, they dropped absolutely incredibly.
 
Matthew Williams, Physiotherapist, OACCP Program:  Prior to this program being in place we found that up to 70% of the patients hadn't had any access to any non-surgical based care for their problem so they were basically going straight on to a surgeon to have their operation.

This has eliminated that challenge, it's linking them into the evidence-based care. In some instances, they won't need surgery, in other instances we're better preparing them for surgery. As a result of that preparation, we've had somewhere between 10 to 15% of patients come off the waitlist because they've improved as a result.
 
Zala Pickett, Patient:  I've dismissed the idea of surgery because I knew that, you know, if I can get up out of bed and walk without any assistance for most of the day without any pain, then I'm on the right track.
 
Matthew Williams, Physiotherapist, OACCP Program:  Ultimately what we want our patients to get towards is to be being able to self-manage their condition, to give them an opportunity to see how they go with non-surgical management. What we need to appreciate is that this is far more than just an injured knee or an injured hip, it renders people very inactive which can have consequences for other aspects of their health. 

For a lot of patients, this changes their life. This has taken them from a place of fear, from isolation where they've developed mental health issues, to a place where they're self-empowered, where they're able to self-manage their condition, whether they're getting back to bingo or they're getting back to visiting friends and family, back involved in the community.
 
Zala Pickett, Patient:  I feel great. This happened almost at the same time that I had an invitation to go to a wedding in Croatia. Dubrovnik is in the old city and you can't go anywhere without having hundreds of steps, up and down in every direction. I did them all and I couldn't have done that without Matt's assistance. I'm doing exercises, maybe I have to do exercises for the rest of my life, I'm happy with that.
 
Matthew Williams, Physiotherapist, OACCP Program:  The big advantage of the Leading Better Value Care initiative is that we're seeing this model of care being replicated across every LHD across New South Wales. Delivering what the model of care is, the evidence-based model of care and we could be capturing these patients a lot earlier on in the journey, in their GP practices and being able to replicate this model of care within primary care, I think is where we really need to take the program next. It's not about numbers anymore, I think we're really starting to recognise it's about better quality care and should involve a number of different health professionals working closely together, communicating with the patient at the centre of that care.
 
Current as at: Monday 20 April 2020
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