Table 3 Stage 3 – changes to the care pathway design and processes
Issue identified | Changes made to address this issue |
|---|---|
DN-4 (neuropathic pain measure) did not identify all patients with clinical symptoms of a neuropathic component to their pain. | Addition of PainDETECT to the clinic assessment questionnaire and trial questionnaires. |
Inconsistencies in the assessment of knee stiffness between the orthopaedic surgeon and extended scope practitioner. | Extended scope practitioners to be provided with a goniometer for the assessment of range of motion. |
Complexity around diagnosing complex regional pain syndrome. | The intervention training manual and the training session will highlight the importance of referring patients if complex regional pain syndrome is suspected, even if formal criteria are not met, to allow for a specialist assessment. |
X-ray film was inadequate to allow assessment of alignment (due to rotation). | Guidance provided in the intervention training manual on standardised wording to use when ordering X-rays. Training will be provided to extended scope practitioners on how to identify a rotated X-ray film. |