Attachment 2 - Program Logic Please delete the worked example and provide your own program logic, as completely as possible. The department will regard this as a draft for further refinement if successful. Brief responses are appropriate. Problem definition Objectives Inputs Activity/ Intervention Outputs Outcomes WORKFORCE (supply) Short term Medium term Long term Workforce is currently not being utilised to its full scope, surgical staff are using time on patients better managed via physiotherapy. Improve the use of existing workforce expertise and skills for the Post Arthroplasty Review (PAR) patient Staff Profession/s Staff numbers (FTEs) Staff salary levels (grades) Staff time spent on Training Supervision Assessing patients on WL for telehealth Absence Staff review times Other Costs Telehealth infrastructure and technology Information Materials Clinic room Selection criteria developed Telehealth process protocols Competencies acquired Learning guidelines and training manual Educating patients Applying AoA guidelines to telehealth review Change in services provided: measured by Increased number of reviews (no./ %) Reduced DNAs (no./ %) Reduced time for each review (no./ %) Decreased staff overtime Change in cost per output : number of reviews at same or less cost surgeon FTE / OOS PT FTE/ OOS Admin FTE/ OOS Increased staff satisfaction and retention within the physiotherapy team. Acceptability of telehealth as mainstream delivery methodology for PAR Reduced acute re- presentations for the specific condition group Enhanced career pathways for physiotherapists Increased surgeon capacity to see new patients and people with complex reviews. Better patient / population health outcomes from total arthroplasty care QUALYS Reducing demand for primary and secondary care Increased workforce flexibility to meet changing needs SERVICES (demand)
Demand for services is exceeding current supply, leading to increasing waiting list numbers and average wait time. Increase the number of patients treated via physiotherapy clinic and discharged from waiting list without surgical review. Telehealth Service inputs determined: No of appointments Timing of appointments Length of OOS Access to telehealth IT Patient Inclusion Criteria for management by telehealth Nos of staff with competencies for telehealth review Evidence base for efficacy of telehealth exists and is applied to PAR reviews Competencies in telehealth review identified and acquired Barriers to change identified Processes and pathways developed Waiting list reduced by x% target (number) Review guidelines met: timing of patient review points all psycho-social aspects reviewed Decreased consultation time for telehealth review compared to traditional appointment Enablers developed and sustainably implemented Improved access to services on time, in an appropriate place, by the right person, first time Reviews as effective as traditional review methodology Risks are eliminated re radiology access and quality Clear critical success factors for and efficient and effective service using telehealth as a mode of choice Sustainably reduced cost for quality , safe and acceptable PAR Telehealth application to a range of conditions that potentially force up costs and demand on health service PATIENT OR CONSUMER NEEDS (health outcomes) Patients are experiencing inappropriately long waiting times, leading to increased pain and reduced function. Improve patient experience via reducing waiting lists and treating patients faster, particularly those not suitable for surgical management. Patient Time on Waiting lists Number of Review appointments available to meet Patient needs (capacity) Assessing people on the waiting list and determining suitability and desire to have review via telehealth Improved patient satisfaction Decreased cost and inconvenience to patient and carer Waiting lists reduced Improved patient/ carer active participation in health care Evidence for replication at larger scale Culture of trust and valuing of methodology Large scale use of telehealth for a range of conditions Choice and cost containment
Timing of review appointments available meet patient needs Ease of access to local imaging services Alternative offered for consumer choice Working up access to local private imaging services Timing of reviews improved Individual functional improvements remain as good or better than traditional model – eg mobility, pain, depressions scores Attachment 3 - Project Timeframe Chart) Planned Commencement Date Expected Completion Date Dates