EP53 Optimizing care through an interdisciplinary hip pain referral triage system: our one-year experience
Notice bibliographique
Résumé
Abstract Purpose Hip pain is a complex condition with multiple pain generators, often leading to misdiagnosis, unnecessary investigations, and treatment delays. This burdens the healthcare system and frustrates patients. Over four years, we developed a high-volume interdisciplinary hip preservation clinic, integrating orthopedic surgeons, sports medicine physicians, physiatrists, and pain specialists. To optimize care delivery, we implemented a novel hip pain referral triage system to streamline the assessment and management of non-arthritic hip conditions. This study reviews our system’s impact after one year. Methods An interdisciplinary team was formed in 2020, supported by Zoom rounds and educational meetings. A website was launched to facilitate referrals, publicized via online events and PathwaysBC. Monthly interdisciplinary rounds involved orthopedics, sports medicine, physiatry, radiology, physiotherapy, and chiropractic care. Referrals followed a hub-and-spoke model, with centralized triaging by orthopedic surgeons based on clinical data and imaging. Patients were directed to orthopedics, sports medicine, or physiatry, depending on their condition and location. Standardized, evidence-based physiotherapy protocols were developed and shared with providers and patients. A retrospective chart review of triage referrals to our clinic from the 2023 calendar year was performed by three independent reviewers. Data points extracted included demographic information, radiologic diagnosis, initial referral date, treatment pathway (surgical or non-surgical), time to first specialist visit, time to treatment (surgery or intervention) and procedure performed. Data is presented through descriptive statistics. Results 169 patients (208 hips) were referred in the 2023 calendar year. Of these, 147 patients were accepted, with an 87% acceptance rate. The most common reason for rejection was due to advanced stage osteoarthritis requiring arthroplasty. The most common diagnoses were femoroacetabular impingement (83 hips), labral tears (56 hips) and osteoarthritis (49 hips). Mean time from referral to first specialist appointment was 104.27 days. Among patients who received injection, mean time to injection was 156.83 days. Mean time from referral to surgery date was 271.31 days, while mean time on the surgical waitlist was 177.12 days. Conclusion Our interdisciplinary triage system has improved access to care for non-arthritic hip pain patients. Future efforts should focus on educating referring practitioners to minimize inappropriate referrals.
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Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
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