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Table 1 Centralized intake providers and potential alternative providers

From: Optimizing the interprofessional workforce for centralized intake of patients with osteoarthritis and rheumatoid disease: case study

 

Providers involved

Potential alternative providers

Stage of process

Clinic 1: rheumatic disease (RD)

Clinic 2: hip and knee osteoarthritis (OA)

Clinic 3: hip and knee osteoarthritis (OA)

Receiving referral

Unit clerk

Executive assistant

Medical office assistant

Optimal providersa in place for this stage of the process

Review referral for completeness

Nurse with RD experience

Referral clerk

Medical office assistant

Optimal providers in place for this stage of the process

Data entry

Nurse with RD experience

Referral clerk

Medical office assistant

Optimal providers in place for this stage of the process

Triage

Nurse with RD experience

Referral clerk

Medical office assistant

Optimal providers in place for this stage of the processb

Unit clerk

Screening

N/A

Surgeon

Surgeon

OA:

 

The clinic only triages referrals; patients are seen by a rheumatologist and allied health team at the rheumatology clinics.

 

General practice physician

 Physiotherapist

 Chiropractor

 Advanced practice nurse

RD: interprofessional MSK team

Assessment

N/A

Surgeon

Surgeon

OA:

Assessment process out of scope. Staff would like the rheumatologist to see patients for initial diagnosis and development of a treatment plan. An interprofessional team would be responsible for case management and ongoing assessment of stable patients.

Medical office assistant

Medical office assistant

 Occupational therapist

Nurse

Nurse

 Kinesiologist

Dietician

Dietician

 Chiropractor

Kinesiologist and/or physiotherapist

Physiotherapist

RD: interprofessional MSK team

Occupational Therapist

  1. aOptimal providers are those operating at the right level; these providers are not overqualified but have the appropriate level of knowledge and skills to complete the task
  2. bOptimal providers include a nurse required for RD but referral clerk or medical office assistant for OA given the clinical distinction between RD and OA. There are over 100 different rheumatic diseases with a multitude of presenting symptoms thus making the referral review challenging