Table 2 Levels of Orthopedists’ Involvement in Clinical Activities, by Episode of Care
From: Orthopedist involvement in the management of clinical activities: a case study
Clinical Activities, by Episode | Site A | Site B | Site C | Site D | |
|---|---|---|---|---|---|
Episode 1: Daily Surgery Scheduling | |||||
Submission of surgery requests | Reactive | Reactive | Reactive | Reactive | |
Follow-up on surgery requests | Inactive | Active | Inactive (parallel management for the permanent orthopedist) | Contributory | |
Participation in surgery scheduling | |||||
Management of problem cases | |||||
Episode 2: Instrument Management | |||||
Equipment orders and delivery | Inactive | Active | Active | Contributory | |
Transmission of information | |||||
Episode 3: Patient Preparation | |||||
Hip fractures | Medical consultation requests | Active or Inactive | n/a | n/a | Contributory |
Elective cases (TKR/ THR) | Patient evaluation | Inactive | Contributory | Inactive, except contributory for the full-time orthopedist | Contributory |
Complex case management | |||||
Transmission of information | |||||
Episode 4: Intraoperative Phase | |||||
Surgery time management | Reactive or Inactive | Contributory | Reactive | Contributory | |
Work organization in the operating block | |||||
Clinical practices improvement | |||||
Daily management of clinical activities | Reactive | Contributory | Reactive | Contributory | |
Episode 5: Postoperative Patient Follow-up | |||||
Routine medical visit | Inactive | Contributory/Active | Inactive, except active for the full-time orthopedist | Contributory/Active | |
Patient discharge | |||||
Intervention in the event of complications | |||||
• Inactive: Not involved in developing management methods and of response to directives and requests • Reactive: Available if needed and responds to requests • Contributory: Contributes to activities to develop management and intervention methods, and delegates application to other clinical staff members; however, orthopedist keep a close eye on planned activities and intervene if necessary • Active: Shows active participation in the development and application of management methods | |||||