Authors (including presenting author) :
Chou CW(1), Long KI (1), Cheung MH(1), Wang HL(1), Cheng CS (1), Kwong SK(1), Cheung WY(2), Ko WK(1)
Affiliation :
(1) Department of Family Medicine and Primary Healthcare, Queen Mary Hospital, Hong Kong West Cluster (2) Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong West Cluster
Introduction :
Orthopaedics Joint Clinic at General Out-Patient clinics (GOPC) in Hong Kong West Cluster has been established in 2016. The establishment of the Orthopaedics joint clinic could significantly reduce the referrals to Orthopaedics SOPC. Moreover, our FM colleagues can acquire advanced clinical skills from the Orthopaedics specialist on management of patients with Orthopaedics problems. In the long run, the techniques learnt could help FM doctors in managing GOPC patients with common musculoskeletal problems and further reduce the referrals to SOPC.
Objectives :
The aim of the joint clinic is to enhance the management of patients with musculoskeletal problems at primary care settings, shorten the waiting time of our GOPC patients for Orthopaedics specialist assessment, and reduce the referrals to the Orthopaedics Specialist Out-patient clinic (SOPC).
Methodology :
An Orthopaedics specialist will come to our GOPC once monthly. With one of our family medicine (FM) colleagues together, they will jointly assess our GOPC patients with pre-defined Orthopaedics problems. In each session of the joint clinic, there are 7 patients being seen. Besides seeing patients, we have also prepared around 10-15 abnormal X-Ray films, CT and MRI films for the Orthopaedics specialist to review together. The management plan of those patients with abnormal imaging would be established then.
Result & Outcome :
From January 2020 to November 2021, there were 153 patients attended Orthopaedics joint clinic. Over half of the patients (56%) required no further investigations or referrals. About one fifth of patients (22%) were referred to Orthopaedics SOPC and around 10% of patients needed to be reassessed in the subsequent joint clinics again. During the same period, there were 183 films reviewed in the Orthopaedics joint clinic. Half of them (50%) did not require further action. One third of them (39%) needed further blood tests, X-rays or MRI as follow up assessment. Only 7% of the patients needed to see again in the subsequent Orthopaedics joint clinics, and only 4% of the patients needed to be referred to the Orthopaedics SOPC for further management.
