Above photo: Meet the advance practice physiotherapists of the Rapid Access Spine Triage Program (l to r): Steve Kotzo, Emily Motyka, Paul Mah and Jennifer Bermingham.
Until recently, a referral to the Vancouver General Hospital (VGH) Brenda and David McLean Integrated Spine Clinic required patience. Wait times for non-emergent spinal complaints were lengthy, but thanks to the advance practice physiotherapists (APPs) of the clinic's new Rapid Access Spine Triage Program, patients are seen faster than ever before.
The program, says Brendan Tompkins, patient services manager, represents a new standard of care.
“Previously, there was a two-year waiting period," he says. “Only 10 out of 100 patients warranted surgery, but all needed expertise on what kind of management would help them."
During the program's one-year pilot, Steve Kotzo and Emily Motyka, both APPs, received hands-on training from seven VGH spine surgeons; they went to lectures and presentations and attended assessments to augment their extensive experience, knowledge and skills in the assessment of neuromusculoskeletal conditions. Working collaboratively with the clinic's medical practitioners and surgeons, they served as each patient's first clinical point of contact, providing comprehensive clinical assessments.
“Patients now access the clinic within 14 days," says Steve. “We're able to determine if they need surgery and, if not, provide them with information that can be coordinated within the community and in consultation with their GP."
“This program is the first of its kind in B.C.," says spine surgeon Dr. John Street. “Similar programs in other provinces only assess low back pain, while ours assesses all spine conditions from head to toe. The APPs provide in-person, comprehensive, evidence-based assessments early on in the evolution of a patient's symptoms, when non-operative care can be most effective. We've also eliminated unnecessary imaging with significant cost savings."
Dr. Marcel Dvorak agrees, adding: “Patients appear to be very satisfied with the APPs' professionalism, knowledge and timely advice. This is a real example of how we can work together creatively across disciplines to respond better to the needs of patients."
In April, two more APPs, Paul Mah and Jennifer Bermingham, joined the program. Like Steve and Emily, they bring experience and expertise, supplemented by spine-specific advanced training, to provide the clinic's patients quality, timely care.
“Our clinic has been the most popular show in town when it comes to back issues and it's incredible to see the wait times going down," says Brendan. “I can see great opportunities in expanding this triage model to other locations across B.C."