The Calgary Foothills Primary Care Network (CFPCN) Medical Musculoskeletal (MSK) Program is based on international osteoarthritis (OA) guidelines. The program supports patients through an interdisciplinary staffed clinic comprised of:
- A physician
- A physiotherapist
- A pharmacist
- A registered nurse
- A kinesiologist
- An occupational therapist
- A behavioural therapist
- A rheumatologist is available in-person monthly, and offers telephone consultations on an ongoing basis.
The program is embedded in the primary care network, which accepts referrals from over 400 physicians. Referrals are accepted for chronic non-inflammatory MSK health conditions. The program is connected with the community through various chronic disease networks- such as the CFPCN chronic pain management program- various gyms and exercise programs.
All patients are given an individual care plan which is created with them based on their condition, learning needs and readiness for change. Patients are seen as needed (once a month, or multiple times a month) in order to facilitate self-management through coaching. Patients are provided with education and exercise recommendations. Telephone follow ups are used to monitor patients’ progress and build support in the home. Discharge is determined based on patients’ care plans, functional improvement and achievement of long term goals. Discharge planning is done with the primary care physician.
This program does not guarantee success and depends on other factors, medical conditions and individual readiness for discharge.
Visit www.cfpcn.ca for more information.