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• W3019322561 abstract "Purpose: A major contributor to the quality of care received by people with osteoarthritis (OA) is the capability of the healthcare workforce to deliver care that is aligned with evidence-based recommendations and a biopsychosocial approach to management. Clinicians feel ‘under-prepared’ to manage OA, lacking knowledge about recommended practice and/or how to implement recommendations into routine care as well as the skills to support patients to make lifestyle changes (such as exercise or weight loss). Defining the core capabilities of health professionals delivering care for people with OA is required to inform content of pre-licensure curricula and professional development programs to ensure training is appropriately targeted to workforce needs. This study aimed to develop a generic trans-disciplinary, skills-based core capability framework for health practitioners to optimise care for people with OA, using consumer participation and an international inter-professional consensus process. The framework is intended to be applicable to all qualified health professionals involved in OA care across the disease spectrum and healthcare settings. Methods: The study was overseen by an international inter-professional Steering Group, established by the International Osteoarthritis Management Programs ‘Joint Effort’ Initiative endorsed by OARSI in 2018. A Steering Group of 14 members from Australia, USA, UK, Netherlands, Denmark, France and Sweden and comprising physiotherapists, rheumatologists, an orthopedic surgeon, an exercise physiologist, and a consumer with OA, was convened. Figure 1 overviews the study phases. We conducted an e-Delphi survey between February and April 2019 to achieve expert consensus on the core capability framework. An international inter-professional Delphi Panel of experts (including Steering Group members) was established to reach consensus on a framework of capabilities, comprising: i) Health professionals involved in OA human research (researchers); ii) Health professionals who provide clinical care for people with OA (clinicians); and iii) Consumer representatives. The Delphi Panel considered a draft framework (adapted from elsewhere) of 131 specific capabilities mapped to 14 broader capability areas across four domains (A: person-centred approaches; B: assessment, investigation and diagnosis; C: management, interventions and prevention; D: service and professional development). Over three rounds, the Panel rated their agreement (Likert or numerical rating scales) on whether each specific capability in Domains B and C was essential (core) for all health professionals when providing care for all people with OA. Those achieving consensus (≥80% of Panel) rating of ≥ seven out of ten (Round 3) were retained. Generic domains (A and D) were included in the final framework and amended based on Panel comments. Results: 173 people from 31 countries, spanning 18 disciplines and including 26 consumer representatives, participated. In Round 1, 19 (21%) specific capabilities did not reach consensus as being ‘important’ or ‘essential’ for inclusion in Domains B and C and were excluded from Round 2. In Round 2, 23 (26%) specific capabilities did not reach consensus agreement for retaining in Round 3, and 17 (25%) of capabilities did not achieve consensus for retention in the final capability framework and were therefore excluded in Round 3. The final framework (Figure 2) comprised 70 specific capabilities across 13 broad areas i) communication; ii) person-centred care; iii) history-taking; iv) physical assessment; v) investigations and diagnosis; vi) interventions and care planning; vii) prevention and lifestyle interventions; viii) self-management and behaviour change; ix) rehabilitative interventions; x) pharmacotherapy; xi) surgical interventions; xii) referrals and collaborative working; and xiii) evidence-based practice and service development). Conclusions: To provide optimal care for all people with OA, health professionals require a diverse array of skills in person-centred approaches; assessment, investigation and diagnosis; management, interventions and prevention; and service and professional development. Implementation of the core capability framework will help individual health professionals and organisations identify training and development needs of the OA workforce, ultimately improving the quality of care and effectiveness of OA services and improving outcomes for people with OA.View Large Image Figure ViewerDownload Hi-res image Download (PPT)" @default.
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• W3019322561 date "2020-04-01" @default.
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• W3019322561 title "Development of a core capability framework for qualified health professionals to optimise care for people with osteoarthritis" @default.
• W3019322561 doi "https://doi.org/10.1016/j.joca.2020.02.681" @default.
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