Total Joint Assessment Centre Joined by the Hips and Knees: A Partnership to Reduce Wait Times for Patients Needing Total Hip and Knee Replacement One of the first of its kind in Ontario, the Total Joint Assessment Centre (TJAC) at North York General Hospital's Branson Site is a joint project created by a team of orthopaedic surgeons, administrators and clinicians at Markham Stouffville Hospital, York Central Hospital and North York General Hospital. The project received initial funding through the Government of Ontario's Wait Time Strategy. The TJAC is a centre of excellence designed to shorten wait times for total joint hip and knee replacement surgery by providing patients with an early consultation and choice of surgical date options. Reducing Wait Times for Surgery and Improving our Patients' Quality of Life The TJAC's goal is to reduce the wait time for patients needing hip or knee replacement, for both consultation and surgery, by offering all surgical candidates a surgery date within 26-weeks of their referral to the Centre. This period is consistent with the provincial access targets established by the Ontario government in December 2005 as well as Pan-Canadian benchmarks. The ultimate goal is to improve the patient's quality of life and promote better patient management care processes. Referrals to the Centre must be made by a physician or a family
doctor. (Physician
referral form and TJAC website) To reach the Total Joint Assessment
Centre, call (416) 635-2415. Innovative Partnerships Put Patients First
The Centre incorporates chronic care self-management into
the care pathway at all stages of the patient's journey, including acute
care, rehab care, community care and the invaluable support of services
like the Arthritis Society and North York General Hospital's Chronic
Disease Self-Management Program. Helping to Make Orthopaedic Surgeons More Available for Surgery "We hope the Centre will help make orthopaedic surgeons more available for surgery by reducing the number of non-operative patients they see in their office. The Centre is staffed by highly skilled clinical professionals with advanced training in musculoskeletal and orthopaedic assessment techniques," says Bibi Rampersad, Manager, Total Joint Assessment Centre. Last year (2005-2006) North York General did 402 hip replacement surgeries, 653 knee replacement surgeries for a total of 1,055 total joint replacement surgeries.
If the assessment determines a patient is either not ready or unwilling
to consider surgery, a plan of care will be developed to help the patient
and primary care physician manage their condition (e.g. pain control,
weight management, improvement in the level of functioning) to maintain
or improve their level of functioning and overall health status. From
a patient's perspective, other factors can affect their willingness
to have surgery, such as living circumstances, employment status, age,
other health conditions and social support structures. |
"The
TJAC is an innovative project that will help all three hospitals accomplish
the extra hip and knee surgeries each has agreed to do under the Ontario
government's Wait Time Strategy," says Dr. Maurice Bent, Chief
of Orthopaedics. "The Centre and the health care partnerships we've
developed put the patient first covering the full continuum of care
incorporating chronic care self-management. It also gives the patient
the choice of getting a quicker surgery date by accepting the first
available surgeon, or choosing the hospital they prefer or a specific
surgeon." 
A
patient should receive an appointment for the TJAC within two weeks
of the referral. On the first visit a patient will be assessed by a
clinician, who is an experienced orthopaedic nurse, nurse practitioner
or physiotherapist. A comprehensive assessment includes physical, social
and lifestyle status. At the TJAC, patients identified as surgical candidates
will move on to see an orthopaedic surgeon at a second visit to finalize
the decision, which should be within another two to three weeks.