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Practice Lead, Musculoskeletal Rapid Access Clinic for Low Back Pain

Position: Practice Lead,
Musculoskeletal Rapid Access Clinic for Low Back Pain Program (1 FTE)
Reports To: Clinical Program Manager


Musculoskeletal (MSK) Rapid Access Clinics (RACs) are being implemented across the province to help people with MSK pain access the right treatment faster. This work stems from the successful pilot program: Inter-professional Spine Assessment and Education Clinics (ISAEC) for low back pain.

ISAEC is an innovative, upstream, shared-care model of care in which patients receive rapid low back pain assessment, education and evidence-based self-management plans. It is designed to decrease the prevalence of unmanageable chronic low back pain, reduce opioid initiation, and reduce unnecessary diagnostic imaging as well as unnecessary specialist referral and emergency department visits. The low back pain RAC is specifically for patients with: (1) persistent low back pain and/or related symptoms (e.g. sciatica, neurogenic claudication) 6 weeks to 12 months post-onset; and (2) recurrent / episodic unmanageable low back pain and/or related symptoms of less than 12 months post-recurrence. The ISAEC model of care is being implemented across the North Simcoe Muskoka (NSM) LHIN as part of the MSK RAC implementation.

The Couchiching Family Health Team will serve as the physical hub for the region’s low back pain RAC. The NSMLHIN will have a dedicated Practice Leader (PL) as well as Advanced Practice Providers (APPs). The PL will be located at the Couchiching Family Health Team and will be responsible for the overall management of the Low Back Pain Rapid Access Clinic within the NSM LHIN. The APPs are located in the community. All Low Back Pain RACs will be connected through a centralized referral and case management system.

Position Summary:

As an integral leader within the RAC team, the Practice Lead (PL) is an innovative, client service oriented clinical expert with both clinical care and leadership responsibilities. The PL will provide clinical guidance and training (in collaboration with the Clinical Sponsor – physician specialist), oversee and supervise clinical and professional practice, and act as a leadership resource for the region’s APPs—mentoring and coaching, monitoring performance and workload, and ensuring high patient and staff satisfaction.

The PL acts as the first and primary point of contact for low back pain patients identified by the community APPs as requiring more advanced assessment and management. As such, the PL plays a key role in identifying signs and symptoms requiring a change in the plan of care, completing requisitions for diagnostic imaging/testing if required, recommend appropriate advanced interventions (e.g. spinal injections), and refer patients for a consultation with a spine surgeon when indicated.

Clinicians who are hired for the RAC for LBP program are expected to have extensive knowledge of the assessment and conservation management of spine related conditions. The ISAEC training that will be provided to the successful candidate will build on this foundational knowledge and will provide clinicians with expanded knowledge and additional options for system management of low back related symptoms.

Successful candidates will be provided with 12 weeks of both practical and theoretical training in low back pain management that will include the ISAEC stratified integrated approaches to assessment and

management of LBP, advanced spine care interventions (e.g. injection therapy) surgical management, pharmacology and diagnostic imaging interpretation. A portion of this training will be in Toronto at the University Health Network.

Roles and Responsibilities:

Expert Practice
• Act as the secondary point of contact for patients with low back pain referred from primary care that require surgical consultation and assessment
• Provide specialized care, education and counseling for patients
• Perform a medical history, physical and health status for patients
• Conduct comprehensive assessment and communication of a diagnosis
• Determine the suitability and eligibility of patients for certain types of surgery, spinal injections and imaging
• Differentiate between inflammatory and non-inflammatory conditions
• Identify signs and symptoms of undiagnosed medical conditions requiring a referral to diagnostic imaging/testing and/or referral to a physician specialist
• Identify and/or order selected diagnostic laboratory tests and therapeutic procedures in accordance with established ISAEC guidelines
• Initiate communication and appropriate surgical and non-surgical referrals based on established ISAEC assessment and referral guidelines
• Establish, communicate and document clinical impressions/medical diagnoses within defined scope of practice
• Develop plan of care in collaboration with the patient/family, surgeon and primary care provider
• Document plan of care per established ISAEC guidelines
• Communicate internally and externally to facilitate plan of care (i.e. other health care professionals)
• Evaluate and revise the plan of care in collaboration with patient/family and primary care provider
• Communicate specific medical diagnoses to primary care provider
• Utilize a patient-centered care approach consistent with patient goals, needs and values.

• Accountable to align activities and performance with strategic goals and objectives of the RAC
• Provide clinical leadership and mentorship to RAC staff, ensuring all prescribed clinical practice standards and guidelines are followed
• Act as agent of change, advancing standards of practice within and external to the program
• Participate in decision-making regarding decisions that impact the RAC
• Develop, implement and monitor a quality management program
• Actively participate in policy and procedure development

Teaching and Learning
• Participate in RAC sponsored regional and central education and training events
• Collaborate with Clinical Sponsor to assess learning needs and facilitate in-service education and support for RAC staff
• Provide formal and informal education internally and externally to RAC team members and primary care providers
• Identify learning needs of patients and primary care providers
• Facilitate knowledge transfer and evidence-based practice

Organization Responsibilities
• Adhere to RAC and hospital standards, policies and procedures, including centralized referral and clinic management processes
• Actively participate in quality and performance management activities, assess and provide input with respect to APP performance evaluation
• Represent RACs in hospital committees
• Act as an active member of the RAC
• Ensure all notes and patient charts are updated in a timely manner
• Maintain and upgrade knowledge and skills
• Maintain current knowledge of policies and procedures
• Maintain confidentiality in accordance with the Municipal Freedom of Information and Protection of Privacy Act
• Work in compliance with Health and Safety laws adhering to safe work practices and procedures established by the CFHT
• Other duties as required

Program Evaluation & Research
• In collaboration with RAC colleagues, implement and conduct evaluation of clinical services related to the program
• Ensure all RAC stakeholders participate in program evaluation activities and comply with reporting requirements
• Provide leadership in identifying and/or enabling research opportunities within the program
• Develop and/or participate in practice-based research

Skills/Knowledge Requirements:
• Has a broad understanding of indications for surgery and risks/benefits for surgery
• Has knowledge of theoretical frameworks and research methods
• Demonstrated ability to work effectively as a member of an Interprofessional team, with excellent interpersonal and communication skills
• Exceptional documentation skills and attention to detail
• A positive and professional attitude
• Excellent time management skills with an ability to multi-task and effectively set priorities
• Excellent oral/written/interpersonal skills
• French Language skills an asset
• Cultural Safety Training eg. FNMI, LGBTQ an asset

Education/Specific Job Requirements:
• Current registration and license with the College of Chiropractors of Ontario or College of
Physiotherapists of Ontario required
• Member of related national/provincial professional association preferred
•  Post-graduate musculoskeletal-related credentialing program or a total or 4 or more years of clinical experience in the musculoskeletal-spine area required
• Valid Driver’s License and access to reliable vehicle is required for travel frequent travel throughout the North Simcoe Muskoka LHIN
• Able to work flexible hours including evenings if required
• Police Record/Vulnerable Record Check

• At least 4 years clinical experience following completion of an accredited, entry-to-practice program in, a regulated health profession of Physiotherapist or Chiropractor required
• Including at least 1 year of clinical experience in the musculoskeletal-spine area required
• Experience in an advanced practice role in an integrated primary care environment, preferred
• Experience in program development an asset
• Experience with an Electronic Medical Record (EMR) and office applications
• Relevant administrative experience preferred

Please submit cover letter and resume including position title in subject line by December 3, 2018 to:

The Couchiching Family Health Team (CFHT) supports diversity, equity and a workplace free from harassment and discrimination. We encourage applications from all qualified candidates, including women, visible minorities, aboriginal peoples and disabled persons. CFHT is committed to providing accessible employment practices that are in compliance with the Accessibility for Ontarians with Disabilities Act (‘AODA’). If you require accommodation for disability during any stage of the recruitment process, please advise our Human Resources Manager. Personal information contained in applications will be used for recruitment purposes and collected as per Freedom of Information (F.O.I.) and Protection of Privacy Act,
1987. While we thank all applicants, only those contacted for an interview will be acknowledged.

Nov 2018