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Virtual Hip and Knee Joint Pain Education Group (JPEG)

by Sam Ogier | Jun 4, 2020 | in Primary/Community Assessment and Triage

We have created a virtual joint pain education group to help encourage patients to self manage their hip or knee joint pain based on the current NICE guidelines for the management of osteoarthritis.

Please see attached conference poster describing the project for further information.

The group provides an initial joint pain education session delivered via the online meeting platform WebEx. Patients are then directed to work independently using the EscapePain online guided exercise resource for six weeks. They are then given a review meeting via Webex and encouraged to continue with self-management if able. 
Patients are safety-netted by being issued with an open appointment for one month which they can use to access further Physiotherapy care if required.

The service has been placed on our patient pathway after self-referral but before receiving traditional Physiotherapy care.  Patients will be directed to the group at triage. This group will enable us to  continue to deliver care during the current coronavirus pandemic. We also hope this group will divert some patients towards self-management of their symptoms and therefore, reduce the demand for the MSK Physiotherapy service.
The group still has potential value for those patients that do go onto receive 1x1 Physiotherapy care. By attending the group, the patient will have been provided with evidence-based information that should aid the treating Physiotherapist's management. 

The group is currently in the final stages of development, we are looking to "go live" by the end of June. Initial feedback from clinical colleagues has been encouraging.

What is needed to sustain the change?

Patients willing to engage with technology to attend the group.
Currently situated within a locally commissioned service. Continuation of the group is dependent on being given sufficient clinical time to run the group. 
Ongoing availability of EscapePain online resources. 

What is your region?

Midlands

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edited on Jul 10, 2020 by Kyle Beacham
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Carol McCrum Jun 5, 2020

Hi Sam
This is a really helpful post to hear about moves to group delivery of care- and learning about the level of engagement and feedback from users will be really helpful to learn from also - thank you - thought- any tips for other services to implement this approach and do participants opt-in ? Any thoughts about weekly group video delivered exercise sessions versus individual home prog? - Thank you!

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Sam Ogier Jun 8, 2020

Hi Carol

Our tips would be:
1. Consider administrative implications and inclusion of outcome measures early in the development process.
2. Establish early peer review from colleagues and trial with a group of test patients.
3. Consider Equipment: an external microphone is really helpful as is a computer with a good webcam and a quiet room to run the sessions from.
4. When designing education content focus on producing an early draft which can then be reworked and developed.

Our patient’s will be directed at triage so they don’t really get to opt in. However they can opt out as part of the inclusion/ exclusion criteria. For anyone not meeting the criteria they will be offered a 1x1 physio appointment in the usual way.

Regarding groups vs weekly exercise class:
We hope that the cohort of patients with early knee/hip OA symptoms will be amenable to self management so we want to facilitate that by having less 1x1 supervision. Our service is also developing weekly supervised online exercise groups for upper limb and lower limb conditions.

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chris mercer Jun 8, 2020

How have patients and staff felt about these changes Sam?

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Sam Ogier Jun 9, 2020

Hi Chris

Initially one or two colleagues expressed concern that this would be replacing 1x1 Physiotherapy for hip and knee OA. They were reassured when it was explained that the JPEG group sits before conventional Physiotherapy in the patient pathway, and that patients will be safety netted through having an open appointment for 1/12 at the conclusion of the group should they need to access further care.
So far feedback from a test group of patients, management, local CCG representatives and colleagues has been very positive.
We are planning to go live week commencing Monday 22nd of June and plan to audit the group as soon as sufficient patients have gone through the pathway.

Sam

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Greta McLachlan Jun 9, 2020

Status labels added: Education, Guidance, Information Sharing, Investment In Technology, Monitoring Of Groups, Pathway Redesign, Patient Activation, Patient Selection, Remote Monitoring, Supported Self Management, Technology (Software/ Apps), Upskilling Of Staff, Video Consulting, Virtual Consulting, Horizon 3

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Greta McLachlan Jun 9, 2020

The idea has been progressed to the next milestone.

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Kyle Beacham Jul 10, 2020

Status labels removed: Education, Guidance, Information Sharing, Investment In Technology, Monitoring Of Groups, Pathway Redesign, Patient Activation, Patient Selection, Remote Monitoring, Supported Self-Management, Technology (Software/ Apps), Upskilling Of Staff, Video Consulting, Virtual Consulting

Reply 0