a value based healthcare approach for knee osteoarthritis (oa) · 2020. 11. 16. · elp pathway:...
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Introduction: Every poster is different. You may wish to modify elements of the design to suit your needs. Keep the colour
scheme and logos to be consistent with the current WCBPS branding /identity. Keep the word count light.
Methods: Here
Results: Here
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Conclusion: Here
A Value Based Healthcare approach
for Knee Osteoarthritis (OA)
BackgroundSwansea Bay University Health Board, Clinical and Value Based Healthcare teams collaboratively worked with the National Exercise Referral Scheme to PILOT a 90 patient Exercise & Lifestyle Programme (ELP), in line with
NICE guidelines for the management of Knee Osteoarthritis (OA).
InterventionPatients were given two options to choose from:
12 weeks of Full intervention: weekly group exercise and diet sessions
12 weeks of Self-management: Arthritis UK education booklets on Osteoarthritis with exercise and diet information
On-going Clinical Support was offered to all patients
Conclusion:Full ELP intervention showed a Significant Improvement in all outcomes measured
Self Management Showed a Mild Improvement in all outcomes.
Next Steps:• Aligning outcomes with national PROMS
• Integrate ELP clinics into CMAT service to improve patient compliance and cost efficiency
• Promoting ELP to Primary and Secondary Care services
• Expanding ELP to other OA joint conditions
• Business case approved to offer ELP to 1000 patients across Swansea Bay UHB in 2021
CHRISTIAN LAMBERT - ADVANCED
PHYSIOTHERAPY PRACTITIONER CMAT, SWANSEA BAY UHB
Primary Care
Physiotherapy
Dietician
NERS
MCAS/CMAT/Diagnostic
X-ray +
Injection
Analgesics
+ Advice/DC
SecondaryCare
Swansea Bay Current Patient Pathway For Non Surgical Management of OA Knee: Methods
90 patients seen by the Clinical Musculoskeletal Assessment & Treatment Service were referred onto the programme. 61 patients attended ELP. 51 patients completed it.
Value is realised when we achieve the best possible health care outcomes for our population with the resources that we have. Outcomes are important milestones in the lives of patients that matter
to them and so we should measure them!In Wales, Value Based Healthcare has been nationally recognised as a practical method to measurably
improve services based on the Principles of Prudent Healthcare, and is also starting to be seen as a leader internationally in our VBHC approaches.
National VBHC 3 Year Action Plan:
Estimated Primary care cost reduction
(GP/Physio/Diet/Scans)
£123,216 **
Reduction in T&O appointments at £69
Est annual saving
£26,910**
19% less Knees Referred
to T&O from CMAT
123 less operations a
Year *Based on 65% conversion to TKR in SBUHB
10 ELP patients sampled 6/12 post program who
reduced analgesia
use by 50%
Benefits:
** based on projected 1000
patients seen in ELP per
year
NERS
Exercise
NERS
Diet Programme “Food Wise”
Education /Self Mx/Outcomes
Follow Up & On going Clinical Support
ELP
Primary Care
Referral
CMAT
ELP Pathway:
“by asking people healthcare becomes personalised, people feel more involved in decisions about their own care. When this happens, people often choose more conservative treatment options because they feel that this is right for them. We should be doing less that don’t help and re-invest in the things that do. This is what we mean by Value Based Healthcare” Professor Chris Jones, Deputy Chief Medical Officer; VBHC National 3 Year Action Plan 2019-2022
3.9
1.2
0
0.5
1
1.5
2
2.5
3
3.5
4
4.5
Full ELP Self Management
Kg
Weight Loss
6.8
1.3
0
1
2
3
4
5
6
7
8
Full ELP Self Management
CM
Waist Loss
9.1
5.7
2.8
1.26
3.3
6.7
0
1
2
3
4
5
6
7
8
9
10
Oxford Knee Score Chair Test EQ-5D-5L BMI Global Rating ofChange
Oxford APQ
Ch
ange
in S
core
ELP Pilot Outcomes
Full ELP Intervention Self Management ELP
NAVJOT KALRA - HEAD OF VALUE
BASED HEALTHCARE, SWANSEA BAY UHB
Dr ROBERT PALMER - CEDAR, CARDIFF & VALE UHB
ANDREW HAXTON - ADVANCED INFORMATION ANALYST, VALUE BASED HEALTHCARE, SWANSEA BAY UHB
PAUL HARRY- PRINCIPLE FINANCE MANAGER, SWANSEA BAY UHB
KERITH JONES - VALUE BASED HEALTHCARE, SWANSEA BAY UHB
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