Exceeding expectations, together
Shoulder ‘one stop shop’
Our MSK clinicians wanted to change the way clinics were delivered for patients with shoulder pain. Standard treatment times were between 4 to 8 weeks from clinical triage to getting a diagnostic report, which led to increased anxiety levels in patients. The average number of appointments in this time was 3, which, even though it is below the national average of 3.5, still means that patients are travelling multiple times for appointments.
We wanted to improve outcomes for patients and increase efficiency at our clinics.
What we did
We adopted a one-stop-shop using a Point of Care Ultrasound Scanning (POCUS) model. These sessions aim to provide an expert MSK assessment using POCUS to decide on the most effective ongoing management plan.
Any patient referred into the service with shoulder pain, but without complex issues is offered an appointment at the Shoulder One-Stop-Shop clinic. Patients are seen for up to 1.5 hours, a long appointment time, but the idea is to spend time with the patient and discuss treatment options on the same day, rather than over a course of 3 shorter appointments over a number of weeks.
The patient will receive the following at the clinic:
- assessment by a Senior MSK physiotherapist for initial hypothesis in view of a potential management plan
- a diagnostic ultrasound scan in view of answering a specific question raised by the senior physiotherapist
- A discussion with the Senior MSK Physiotherapist with ultrasound findings to discuss their recommended treatment options in view of Shared Decision Making (SDM)
- If an orthopaedic opinion or steroid injection is considered appropriate, patients will see an Advanced Physiotherapy Practitioner (APP). All patients receive a personalised exercises programme prescribed by the senior MSK physiotherapist.
Patients are empowered to make their own choice to access a group exercise programme or return to the clinic via patient activated follow-ups.
Patients are seen and treated more quickly, resulting in increased patient satisfaction and improved health outcomes. Patients receive their diagnostic report at the OSS clinic, and the majority of patients require a single episode of care and feel equipped to self-manage their problem.
Clinic efficiency has improved: Average number of appointments per patient has reduced from 3 to 1.5 attendances.
Total clinic time has reduced by 5% and onward referrals for further imaging or to secondary care have reduced from 11% to 5%.