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Physician assistant role pilot aims to help improve access to hip and knee replacement surgeries

Three physician assistants are joining the division of orthopedics at the QEII Health Sciences Centre, through a three-year pilot program to evaluate the role and increase access to hip and knee joint replacement surgeries.

Physician assistants (PAs) are health care providers who practice medicine in collaboration with, or under the supervision of a physician. They are trained to perform many clinical procedures traditionally performed by a physician.

Nova Scotia Health Authority has received support from the Department of Health and Wellness, and the College of Physicians and Surgeons of Nova Scotia to launch the pilot. The Department of Health and Wellness is providing funding for the roles under NSHA’s multi-year hip and knee action plan, announced in the fall of 2017. Presently, physician assistants are not licensed or regulated in Nova Scotia. The College is offering support for the project, allowing physicians to delegate some clinical activities to physician assistants over the course of the pilot.

“I’m pleased the Nova Scotia Health Authority and the College of Physicians and Surgeons have worked together to pilot the physician assistant role in Nova Scotia. Innovation is essential when it comes to addressing wait times. This program is part of a larger strategy to improve access to care and reduce wait times for hip and knee replacements,” said Randy Delorey, Minister of Health and Wellness.

“I look forward to seeing the results of this pilot and how it may benefit Nova Scotians.”

“Nova Scotia’s physician resource and wait list issues call for innovation and collaboration, and we are grateful to the College and the Department of Health and Wellness, for their support,” said Dr. William Oxner, chief of the division of orthopedic surgery for the QEII Health Sciences Centre and Dalhousie University.

“This pilot will enable us to explore how physician assistants might complement our roles. We intend to demonstrate that they can safely and effectively help us address orthopedic wait times, by building capacity within our surgical teams.”

Under the pilot, the physician assistants will be employed by Nova Scotia Health Authority. They will provide general medical care and support surgical care for joint replacement patients, including consultations, surgery, post-surgical care, discharge and follow-up care.

Among their responsibilities, physician assistants will:
• support care in orthopedic assessment clinics,
• obtain medical histories,
• complete physical examinations,
• document consults,
• help arrange other service consults (i.e. dietitian, home care, social work),
• support patient care rounds,
• assist in surgeries,
• support post-operative orders and in-hospital management of patients and
• arrange follow-up care, including outpatient clinics and communication with referring
providers

Physician assistants will also have the authority to prescribe certain drugs to patients under the supervision of their supervising orthopedic surgeon. They will follow a set list of acceptable medications including some pain medications, antibiotics, anti-inflammatories and medications to help with nausea and vomiting.
Job descriptions have been finalized and recruitment will begin this month. To be eligible for the pilot, individuals must be fully trained in another province and be accredited under the Canadian Association of Physician Assistants (CAPA).
It is anticipated that physician assistants will be hired and trained this fall in order to begin supporting orthopedic care early next year.
Nova Scotia’s hip and knee action plan has introduced a new intake process and wellness model for hip and knee joint replacement patients that is improving access and care. Under the plan, more than 80 full-time equivalent (FTE) positions have been added across the province to date, along with four new orthopedic surgeons and three anesthesiologists. Other roles have included physiotherapists, dietitians, registered nurse first assistants, nurse practitioners and more. Learn more about the plan at www.nshealth.ca\hip-and-knee.