Patients Know Best (PKB) has been used by different Orthopaedic teams, from post-operative care, physio, pain and rheumatology teams for many years to better manage their cohort of patients.
With over 200 different musculoskeletal conditions and the current NHS waiting lists, orthopaedic patients are experiencing longer than usual waiting times for appointments, procedures and operations.
This deploy page will show you how different orthopaedic services can use PKB and features teams are already using with their patients.
Current problems
Teams experience a high level of face-to-face appointments
Telephone conversations are lengthy
Teams want to give patients online resources to support self-management
Teams want patients to have access to their blood results
Teams want to enable digital consent
Patients travel long distances for short hospital appointments
With large waiting times, patient conditions can improve and deteriorate, meaning care and health needs change
High DNA rates
PKB solutions
A central, secure place for information and healthcare data to sit in the hands of the patient
Empowers patients to contribute to their own goals and care plans
Provides access to prevention and health promotion resources
Access to management advice, with patients being fully involved in their care through shared decision-making and self-management
Enhanced recovery care plans for elective recovery
Supporting patients at home
Universal messaging, the ability for patients and teams to send messages in a timely, flexible way and all in the patient's record
PKB features
There are key PKB features all orthopaedic services can use with their patients to support them while they wait, both preop and post-operatively. A list of them is below.
Messaging
Patients have access to message their healthcare team(saving time on the phone)
The Admin team can triage messages. Either resolving or passing onto another speciality team
Universal Messaging is the ability for patients to message clinical and non-clinical teams
Team-based messaging allows teams to automatically receive secure messages and consultations as a group rather than as individuals
Library
Disease and condition information with advice and resources
Treatment plans, for example, a rehab program with videos and advice a patient needs to watch and read each week
Rehabilitation information
Advice on Living well, including exercise, healthy eating, quitting smoking and alcohol recommendations
Details and links to National and local support groups and website
Professional alliance information
Treatments options for orthopaedic conditions and pain management
Care plans
PKB care plans can be used at every stage of a patient's condition journey, below are some of the care plan templates being used and templates that can be created.
Living Well for Longer
Condition information and resource care plans
Orthopaedic monitoring condition plan (here is an example of a cardiology monitoring care plan)
Mental health wellbeing information and resource
Rehab, physical activity and musculoskeletal health
Generic support care plans from physiotherapy, podiatry, occupational therapy, orthotics teams
Enhanced recovery care plan
Osteoarthritis Care Plan Template
There are a number of other orthopaedic care plan templates that have been created for teams, a list of them are below. If you would like to see them in full please ask your Success PM.
Consultations
PKB allows patients to complete any forms, surveys or questionnaires (collectively called 'Consultations'). Consultations can be sent on an individual basis or sent to a whole cohort of patients. The output of the consultations can be aggregated and anonymised and is available via the API or as a CSV download.
Teams can get patients to fill in consultations periodically, in some cases these are pre-appointment or post-operative assessments. Below are some of the consultation templates being used by teams.
Annual Review and Flare-Up questionnaires
MSK-HQ short questionnaire
Symptoms and quality of life questionnaire
Pain questionnaire
Add and view data
Patients can view hospitals and GP data where an integration with PKB has been set up
Data can include blood tests, x-ray reports, clinic and appointment letters, appointments and discharge summaries
Patients can add information themselves, including operations and conditions
Patients can track key measurements and add any symptoms related to their orthopaedic condition
Benefits
Individualised care plans
Appropriate resource library specific to the patient’s condition
Timely and flexible messaging between patients and team
Digital appointment letters and appointments
Access to laboratory results
Symptom and measurement tracker
National quality of life questionnaires
Digital consent
Completion of consultations and PROMs
The ability for hospital PAS to add patients to the relevant team in PKB (i.e. pain/surgical/rehab team)
Example Goal for using PKB
Reduce the number of patients not attending appointments (DNA) of the rheumatology team by Sept 2023 (12 months post team go live) from (current DNA rate) to ( %) by sending all appointment letters and appointment details into PKB instead of by post. Current DNA rates are (%). 12 months post go live, the team compare DNA rates of patients with and without a PKB record. It is a local NHS priority to reduce DNAs to save money.
Workflow for Orthopaedic patients
The workflow below shows how PKB can be used in preop and post-operative assessments by giving patients access to their PKB record using the care plan and consultation functionality.
Workflow for orthopaedic consent
Teams can use the care plan feature to gather informed consent before operations and procedures. This workflow diagram below shows how teams can send the consent care plan to their patients to look over and sign before they come into the clinic/hospital. For more information on how PKB manages consent please click here.
Use cases of PKB
The below examples show how PKB is being used in orthopaedic services, if you would like to know more about these teams and want to start using PKB in your service please speak to your Success PM or look at our case studies here for more examples of how PKB is being used in other specialty areas.
Rheumatology
PKB making a big difference to rheumatology patients in Swansea Bay services by giving patients access to their blood results and clinical documents
Giving different Allied Health Professionals the ability to access patients' records to provide a holistic care approach to patients within the Rheumatology Department. By educating patients, the team want to reduce the number of unnecessary contacts via the Advice Line and to allow virtual clinics to avoid the need for a patient to attend the clinic or even require a telephone call.
Virtual Orthopaedic Rehabilitation at Hywel Dda
Hywel Dda University Health Board developed and implemented a virtual, tiered, multi-disciplinary orthopaedic prehabilitation service with partners in industry. Patients are assessed and stratified onto one of three different virtual patient centred tiers of prehabilitation based on their clinical, physical and psychological needs utilising digital platforms.
Read the full Case Study here.
The Persistent Pain team at Hywel Dda
The team are working with patients with Osteoarthritis and Fibromyalgia as part of a study to see how the use of a PHR helps improve patient outcomes. The team are using consultations and library resources to support patients living with long-term pain. This includes access to resources about their condition, exercises, sleep hygiene, goal setting and the ability for patients to upload their own health data such as measurements, and to respond to questionnaires.
Physio team
Using PKB to provide resources via the library for patients discharged without follow-up and for patients on a 6-month PIFU 'discharge' with a shared care plan, library resources, questionnaires and team messaging.
Further information
8 Week Orthopaedic Prehabilitation Plan preoperative care plan
Consent care plan templates: how to do informed consent through a PKB care plan before surgery
ACL Reconstruction Proforma care plan template: enhance recovery care plan for orthopaedic patients in hospital and post-discharge
PKB making a big difference to rheumatology patients: giving patients access to their blood results and clinical documents
Pre-clinic consultation: (coming soon)
Peri-operative specialty team: how PKB can be used pre and post-operatively
University Hospitals of Derby and Burton NHS Foundation Trust Dermatology: Using messaging and pre-appointment consultations to decrease the number of phone calls, saving both patient and clinician time.