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  • Innovative MSK clinic welcomes third-year IMP students for orthopedic rotations

    Jul 6, 2017 | Posted by: Joy Kirstin & Rhys Mahannah

    The Island Medical Program (IMP) is pleased to announce that orthopedic rotations for third-year students are now taking place at Rebalance MD, Victoria’s primary musculoskeletal clinic.

    Introducing Rebalance MD

    Rebalance features a wide range of musculoskeletal (MSK) specialists who work out of a single clinical site, facilitating greater collaboration between different kinds of healthcare disciplines. Indeed, all of Victoria’s 18 orthopedic surgeons work here, as do eight sport medicine physicians, three physiatrists (rehabilitation medicine specialists), and 11 physiotherapists. Ancillary services such as splinting, bracing, orthotics, and diagnostic imaging are also on site; the clinic even coordinates visits from other health professionals for consults and workshops.

    Since opening its doors in 2013, Rebalance has played a key role in revolutionizing MSK care in Victoria. It has dramatically reduced referral times (from an average of 40 weeks to eight weeks); increased patient accessibility and quality of care; and streamlined every step of the diagnostic, treatment, and recovery process for both surgical and non-surgical cases. Most of the area’s patients who are referred for MSK care go to Rebalance.

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    Helping Train Tomorrow’s Doctors

    At Rebalance, third-year IMP students work with a multidisciplinary healthcare team to treat patients for a wide range of MSK injuries and conditions, helping to provide patients with easy access to the right type and level of care for their condition.

    “These orthopedic rotations are quite unique, in that they provide students with a wide exposure to an integrated system of care for MSK problems,” says Dr. Laura Farrell, Assistant Dean of the IMP. “Not only do they learn from orthopedic surgeons and sports medicine physicians, but students also work with physiotherapists and physiatrists to understand their roles in the diagnosis and management of MSK issues. In addition, they spend time with Rebalance’s “Joint Program Navigators,” who guide hip and knee-replacement patients through the treatment process, including preparation for surgery and post-operative rehabilitation.”

    In addition to time spent at the Rebalance clinic location, students visit Royal Jubilee or Victoria General Hospitals to assist in an operating room during surgical procedures, and to rotate through the Cast Clinic.

    Rebalance is no stranger to student education. For years, it has hosted IMP fourth-year students for electives, and has provided training and co-op placements for students from a variety of other UVic disciplines, such as Bioengineering, Kinesiology, and Health Informatics. The clinic has also participated in medical residencies and fellowships in response to requests from UBC and other post-graduates from across the country.

    “We are excited about the possibilities for education and health innovation that will come from this new working relationship with the Island Medical Program,” says Rebalance CEO, Stefan Fletcher. “We believe that our collaborative, patient-centric model is a good example of what’s possible for the future of health care.”

    Right Person, Right Place, Right Time

    Rebalance MD’s cheery 14,500 square foot clinic in Saanich’s Uptown Centre provides a full range of musculoskeletal outpatient services for both surgical and non-operative conditions.

    One of the things that sets Rebalance apart from other multidisciplinary clinics is that there is no “pay-to-play”. Their service model was designed by physicians and specialists in close communication with Island Health, the Ministry of Health, and primary care providers – ensuring that the treatment model works as efficiently and effectively as possible within the broader health system.

    Reduced Referral Times

    Rebalance’s FAAST referral model (First Available Specialist Triage) has cut referral times from an average of 40 weeks to eight weeks. It ensures that patients are quickly directed to the most appropriate specialist for their condition. FAAST provides:

    • a single point of entry for all musculoskeletal referrals (previously, there were five)
    • a standardized referral template, developed in conjunction with primary care providers
    • standardized x-ray views which have been adopted across the system.

    The Scrum Room

    One of the key spaces at Rebalance is the Scrum Room. Here, musculoskeletal physicians and other professionals have work stations in a conference room, allowing them to quickly discuss and gather second opinions on complicated cases.

    Joint Program Navigators

    Five “navigators” (four nurses and a physiotherapist) work out of a different part of the clinic, liaising with hip and knee replacement patients to guide them through each step of pre- and post-operative care and rehabilitation. The navigators help patients understand the process and ensure that all appropriate consultations and ancillary services are scheduled in a timely fashion.



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