Q Exchange
“EmpowerArthritis: Navigating Care Choices for Lower Limb Osteoarthritis”
- Proposal
- 2024
Meet the team
Also:
- Sivaramkumar Shanmugam ( Senior lecturer Glasgow Caledonian University)
- Emond, Sofia Do Nascimento Emond (DIP student Glasgow Caledonian University)
What is the challenge your project is going to address and how does it connect to the theme of 'How can we improve across system boundaries?
The management of osteoarthritis poses considerable challenges, particularly in applying evidence-based realistic healthcare strategies, Healey et al.
In 2023, a survey within GG&C area revealed disparities in the referral practises amongst different healthcare professional groups. Variable levels of knowledge regarding third and four sector support available for patients was also noted. Despite these hurdles consultations within primary care, orthopaedics and MSK physiotherapy, groups showed motivation and interest in improving service navigation for both healthcare professionals and patients. A successful tool should aid more equitable healthcare consultations for individuals with this long term condition.
What does your project aim to achieve?
AIM: the project endeavours to design and implement a versatile tool that aids osteoarthritis patients identifying their needs and preferences for support and care.
Objectives
Develop an adaptable tool , which can be implemented across different healthcare settings and interactions with patients.
Identify any potential barriers and positive influences with regards to implementation and design. Use these to inform the tools design.
Evaluate the tools usability, practicality and impact on both service users and healthcare providers. To include diverse patient groups
Does the use of this tool influence decision making by the patient and/or the healthcare professional. If so what are these changes?
How will the project be delivered?
The initial version of the tool has been conceptualised but awaits empirical testing. The preliminary phase will involve pilot testing within physiotherapy settings in primary care MSK and orthopaedic outpatients through focus groups and think aloud techniques. Feedback will guide iterative redesign and content adjustments.
Extended testing to diverse healthcare professional groups to evaluate the tools broader applicability.
Testing with diverse patient polulations to ensure it serves our GG&C population
How is your project going to share learning?
This project explorers whether a universal tool can be utilised to standardised access and equity in osteoarthritis care across the healthcare continuum by facilitating informed decision making.
The initiative aims to create a more cohesive patient centred approach to osteoarthritis management, potentially serving as a model for addressing similar challenges in other long-term healthcare conditions.
Can a ‘low cost’ tool provide adequate support for patients regarding decisions about their own care.
Learning will also be available regarding the process we have adopted to evaulate the tool and its benefits and pitfalls.
How you can contribute
- Scoping of other similar projects undertaken to gain insight, perhaps used in other patient cohorts.
- Techniques used to aim information about its usability, practicality and impact on both service users and healthcare providers.
Plan timeline
| 20 Mar 2024 | Does tool change patients decision making and utilisation of services |
|---|---|
| 20 Mar 2024 | advise regarding rool out to all services across GG&C/ nationally |
| 20 Mar 2024 | review is design is practical across all healthcare settings |
| 20 Mar 2024 | test with different diverse patient groups |
| 2 Jun 2024 | Recruit MSK Physios to take part (primary care, acute, community) |
| 14 Jul 2024 | Radip testing to assess usability/ design flaws |
| 18 Aug 2024 | Adaptions made to tool |
| 15 Sep 2024 | Focus groups MSK staff and patients, various methods for themes |
| 13 Oct 2024 | Adapt tool as required |
| 8 Dec 2024 | Implement tool is clinical environment across PC, Community and acute |
| 23 Mar 2025 | review of findings and plan for next steps |
Comments
Margot Cohen 13 Mar 2024
Thank you Michelle for your comments and the resource. The more I implement 'shared decision' making you realise the skill involved in delivering this approach to your consultations and often its about unlearning skills you have implemented for years.
Much appreciated
Margot
Hilda Campbell MBE 7 Mar 2024
Great idea, wonder are you linked with Versus Arthritis in Scotland https://www.versusarthritis.org/in-your-area/scotland/ also the health and social care alliance digital project https://www.alliance-scotland.org.uk/digital/digital-health-and-care/discover-digital/
kind regards
Hilda
Margot Cohen 13 Mar 2024
Thankyou for your suggestions. I have been in close contact with VA and indeed they had a look at my first draft and are happy to help generate focus groups for us to use during the testing process. Will investigate the your alliance suggestion.
Much appreciated
Margot
Nuala Hampson (she/her) 28 Feb 2024
This is a really interesting idea. I love the aim to empower patients to self-manage their conditions. Is the toolkit going to be online / digital? Have you considered accessibility and inclusivity eg thinking about people who cannot access online materials, different language needs etc?
I like the earlier suggestions about measuring outcomes. You might consider measuring uptake of the advice / use of recommended services / you could consider a measure on medicine use for the OA (is there lower medicine use in those with access to the tool?)
Good luck!
Margot Cohen 13 Mar 2024
To answer the second part of your question, once an operational model is ready then testing on non English speaking groups is essential not only a direct translation of the tool but also does the tool represent their needs and beliefs around healthcare and osteoarthritis. This would be fascinating to explore.
Kind regards
Margot
Margot Cohen 13 Mar 2024
Thank you Nuala
The plan is to try the tool as a paper/ electronic flow chart. The longer term plan would be to make this more digitally based e.g. flow chart is represented as a decision tree to service users. The long term plan is if this format is useful for patients and staff would be to replicate this for each health board where local services could be added as required. Measuring impact is a difficult one as there are many ways patients can assess services and healthcare professionals. This i suspect might need to wait until tool is operational. Had thought about looking at patients expectations about what they what/ need regarding help and then compare this to after being exposed to the tool. This way we can estimate the impact on services.
Thank you for your interest and suggestions
Much appreciated
Margot
David Elder 28 Feb 2024
This is a really interesting project. It would be great if you were able to measure and share learning of impact. This might include any reductions in waiting times, service users following different pathways that might reduce waits for others, increased patient well-being and any reduction in costs.
Margot Cohen 13 Mar 2024
Thank you David
Interesting points, Once the tool is operational we could look at patients thoughts/ expectations before using the tool and then afterwards. This would give us an idea as to how this might change the path for the patients and therefore allow us to see changes in pathways, utilisation of pathways etc. The same could be easily done from the healthcare professional side of things e.g. our data suggests physiotherapy is the most preferred onward referral option for GP and Ortho consultants, this may change if this tool was implemented. On a longer term basis we could track a cohort of patients and look for implications there e.g. medication usage.
Thank you
Margot
Michelle Beattie 26 Feb 2024
Another super idea. Such a practical aim to increase patient decision-making yet difficult to do reliably. Sounds like think aloud exercises with a patient group would be a good next step. Decision-making tricky to measure. Not sure if you've heard of the OPTION scale for measuring patient involvement but it might be useful. Shared decision making: developing the OPTION scale for measuring patient involvement | BMJ Quality & Safety
Comments are now closed for this post.