PA Hospital’s Orthopaedic Outpatient Unit (OOU) and Security Unit (SECU) are celebrating after a 12-month pilot of the Prison Telehealth Project (PTP) substantially improved orthopaedic appointment attendance rates and clinical efficiency.
Developed and launched by PAH Ortho Connect CNC Maria Van Ansem, the PTP was established to offset an increasing failure to attend (FTA) rate for orthopaedic appointments at PAH’s co-located SECU, making healthcare more accessible and more efficient for incarcerated patients.
“Before COVID, FTA rates were at around 30 per cent, and that increased to 50 per cent during COVID,” Maria said.
“There are accessibility issues that are beyond our control, like inmate refusal, transport issues, court appearances and of course COVID, which significantly complicated the appointment process for these patients because of social distancing requirements.”
The only service of its kind in Queensland, the PAH SECU hosts a 12-bed inpatient and outpatient service dedicated to inmates in need of emergent care. With a chronically high FTA rate, Maria was determined to make a positive impact at both sides of the service.
“I’m focused on providing the best care that we can for our patients, regardless of their background. If we can make the service more efficient and timelier, it helps everyone.”
With orthopaedics accounting for 15 per cent of the SECU’s 6,000 annual appointments, bringing medical imaging closer to home was the first step to improving efficiency.
“Most of our ortho patients need some form of medical imaging, and going back and forth to get their X-rays and then follow-up appointments can take weeks. Over the last few years, the prisons have acquired their own X-ray machines and trained operators, and that negates the need for coordinating unnecessary travel and speeds up the treatment process.”
In just 12 months, the project has successfully reduced FTA by 20 per cent compared to COVID figures, while telehealth appointments increased tenfold.
“We have a much more efficient clinic now, because we’re able to see more of the patients that we’re booking and we’re getting their results to them faster,” said Maria.
“Telehealth appointments now account for 35-40 per cent of the clinic, representing over 300 appointments p.a. compared to less than 30 p.a. previously. Overall FTA rate has been reduced by five per cent compared to pre-COVID, and 20 per cent compared to during COVID.”
In light of the project’s ongoing success over the last 18 months, Maria has her sights set on making the service a permanent fixture at PAH.
“While there are still factors outside of our control, the data shows the uptake of telehealth is making a significant impact. We had 160 more completed appointments during the trial, with funding exceeding the cost of coordinating the service. Furthermore, reduced numbers of inmates travelling to the hospital also means Qld Correctional Services stand to save over $130,000 pa in transport costs,” she said.
“It’s a worthwhile project and a good use of my time. We’ve demonstrated tangible improvements for both the inmates and the health system, all in all providing a compelling argument for continuation of the service.”
As she closed in on 30 years in orthopaedic nursing, Maria’s PTP case study claimed Best Paper at the SFT-23 National Telehealth Conference in Adelaide last November.