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  • University of Toronto Libraries - UOTL  (5)
  • 1
    In: Canadian Prosthetics & Orthotics Journal, University of Toronto Libraries - UOTL, ( 2018-12-12)
    Kurzfassung: BACKGROUND: Evidences of sustainable clinical benefits of bone-anchored prosthesis (BAP) using osseointegrated fixation over typical socket-suspended prostheses are becoming more probing. This influx of individuals to be fitted with BAP has pressed government organisations to adjust their policies. However, the appraisal of consumer’s experience for the provision of BAP founded by government organisation is yet to be developed. This descriptive study shares the experience gained by a government organisation, namely the Queensland Artificial Limb Service (QALS), while developing a specific BAP-inclusive continuous quality improvement (CQI) procedure. OBJECTIVE(S): The primary objective was to present the methods and outcomes of key steps required to plan and create this CQI procedure. The secondary objective was to highlight key barriers and facilitators of the transition from a socket-focused to the proposed BAP-inclusive CQI procedure.  METHODOLOGY: The re-design process of the CQI procedure for 65 current QALS’s consumers with BAP involved a two-step process for the planning (e.g., case-mix, stakeholder) and creation (e.g., diagnosis, technical options, cost). FINDINGS: Prosthetists labour toward CQI procedure represented 1.3 hrs out of 22 hrs and AUD$213 out of AUD$3,300 or 6% of the whole procedure for the provision of BAP. The time spent by a prosthetist, consumer and QALS staff represented 24%, 24% and 53% of the time of the CQI procedure, respectively. The cost of prosthetist and QALS staff labour represented 70% and 30% of the CQI procedure, respectively. CONCLUSIONS: This descriptive study shares the workings and methodology that government organisations, such as QALS, can use to re-design a CQI procedure for comprehensive appraisal of the provision of prosthesis that could be inclusive of BAP and affordable while minimally time-consuming for prosthetists. The transition from a socket-focused to the proposed minimally disruptive BAP-inclusive CQI procedure was facilitated by prior knowledge of BAP treatment, early identification of the stakeholders and adaptation of current CQI procedure. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/31326/24425 LAYMAN’S ABSTRACT There is evidence supporting the long term clinical benefits of bone-anchored prosthesis (BAP) using an osseointegrated fixation over typical socket-suspended prostheses. The increasing number of individuals treated with osseointegrated fixation has pressed government organisations to adjust their policies for fair and equitable provision of prosthetic care. However, the appraisal of consumer’s experience for the provision of BAP by government organisation is yet to be developed.  This descriptive study has fulfilled this need by sharing the experience gained by a QALS while developing a specific BAP-inclusive continuous quality improvement (CQI) procedure. This study revealed that government organisations can design a CQI procedure for comprehensive appraisal of the provision of prosthesis that could be inclusive of BAP and affordable while minimally time-consuming for prosthetists. The transition from a socket-focused to the proposed minimally disruptive BAP-inclusive CQI procedure was facilitated by prior knowledge of BAP treatment, early identification of the stakeholders and adaptation of current CQI procedure. How to Cite: Frossard L, Ferrada L, Quincey T, Burkett B, Berg D. Development of a government continuous quality improvement procedure for assessing the provision of bone anchored limb prosthesis: a process re-design descriptive study. Canadian Prosthetics & Orthotics Journal, Volume 1, Issue 2, No 4, 2018. DOI: https://doi.org/10.33137/cpoj.v1i2.31326
    Materialart: Online-Ressource
    ISSN: 2561-987X
    Sprache: Unbekannt
    Verlag: University of Toronto Libraries - UOTL
    Publikationsdatum: 2018
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 2
    Online-Ressource
    Online-Ressource
    University of Toronto Libraries - UOTL ; 2021
    In:  CANADIAN PROSTHETICS & ORTHOTICS JOURNAL Vol. 4, No. 2 ( 2021-09-21)
    In: CANADIAN PROSTHETICS & ORTHOTICS JOURNAL, University of Toronto Libraries - UOTL, Vol. 4, No. 2 ( 2021-09-21)
    Kurzfassung: The emergence of skeletal prosthetic attachments leaves governmental organizations facing the challenge of implementing equitable policies that support the provision of bone-anchored prostheses (BAPs). In 2013, the Queensland Artificial Limb Service (QALS) started a five-year research project focusing on health service delivery and economic evaluation of BAPs. This paper reflects on the QALS experience, particularly the lessons learned. QALS’ jurisdiction and drivers are presented first, followed by the impact of outcomes, barriers, and facilitators, as well as future developments of this work. The 21 publications produced during this project (e.g., reimbursement policy, role of prosthetists, continuous improvement procedure, quality of life, preliminary cost-utilities) were summarized. Literature on past, current, and upcoming developments of BAP was reviewed to discuss the practical implications of this work. A primary outcome of this project was a policy developed by QALS supporting up to 22 h of labor for the provision of BAP care. The indicative incremental cost-utility ratio for transfemoral and transtibial BAPs was approximately AUD$17,000 and AUD$12,000, respectively, per quality-adjusted life-year compared to socket prostheses. This project was challenged by 17 barriers (e.g., limited resources, inconsistency of care pathways, design of preliminary cost-utility analyses) but eased by 18 facilitators (e.g., action research plan, customized database, use of free repositories). In conclusion, we concluded that lower limb BAP might be an acceptable alternative to socket prostheses from an Australian government prosthetic care perspective. Hopefully, this work will inform promoters of prosthetic innovations committed to making bionic solutions widely accessible to a growing population of individuals suffering from limb loss worldwide. Article PDF Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/36210/28330 How To Cite: Berg D, Frossard L. Health service delivery and economic evaluation of limb lower bone-anchored prostheses: A summary of the Queensland artificial limb service’s experience. Canadian Prosthetics & Orthotics Journal. 2021; Volume 4, Issue 2, No.12. https://doi.org/10.33137/cpoj.v4i2.36210 Corresponding Author: Laurent Frossard, PhD, Professor of BionicsYourResearchProject Pty Ltd, Brisbane, Australia.E-Mail: laurentfrossard@outlook.comORCID number: https://orcid.org/0000-0002-0248-9589
    Materialart: Online-Ressource
    ISSN: 2561-987X
    Sprache: Unbekannt
    Verlag: University of Toronto Libraries - UOTL
    Publikationsdatum: 2021
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 3
    Online-Ressource
    Online-Ressource
    University of Toronto Libraries - UOTL ; 1998
    In:  Quaderni d'italianistica Vol. 19, No. 2 ( 1998-10-01), p. 161-162
    In: Quaderni d'italianistica, University of Toronto Libraries - UOTL, Vol. 19, No. 2 ( 1998-10-01), p. 161-162
    Materialart: Online-Ressource
    ISSN: 2293-7382 , 0226-8043
    RVK:
    Sprache: Unbekannt
    Verlag: University of Toronto Libraries - UOTL
    Publikationsdatum: 1998
    ZDB Id: 42580-1
    ZDB Id: 2572163-X
    SSG: 7,30
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 4
    Online-Ressource
    Online-Ressource
    University of Toronto Libraries - UOTL ; 2000
    In:  Quaderni d'italianistica Vol. 21, No. 1 ( 2000-01-01), p. 29-45
    In: Quaderni d'italianistica, University of Toronto Libraries - UOTL, Vol. 21, No. 1 ( 2000-01-01), p. 29-45
    Materialart: Online-Ressource
    ISSN: 2293-7382 , 0226-8043
    RVK:
    Sprache: Unbekannt
    Verlag: University of Toronto Libraries - UOTL
    Publikationsdatum: 2000
    ZDB Id: 42580-1
    ZDB Id: 2572163-X
    SSG: 7,30
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 5
    Online-Ressource
    Online-Ressource
    University of Toronto Libraries - UOTL ; 2019
    In:  Canadian Journal of Academic Librarianship Vol. 5 ( 2019-05-24), p. 1-3
    In: Canadian Journal of Academic Librarianship, University of Toronto Libraries - UOTL, Vol. 5 ( 2019-05-24), p. 1-3
    Materialart: Online-Ressource
    ISSN: 2369-937X
    Sprache: Unbekannt
    Verlag: University of Toronto Libraries - UOTL
    Publikationsdatum: 2019
    ZDB Id: 3097806-3
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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