New Resource! Physiotherapists & Kinesiologists Education & Scope Comparison

In 2007, the Ministry of Health’s Health Force Ontario recommended that providing clarity on roles and responsibilities, including scopes of practice and competencies, is important to building a strong foundation for interprofessional care.

OPA has developed a resource to help with that clarity for physiotherapists and kinesiologists. The resource aims to increase understanding of these two regulated professions in the physical rehabilitation sector in Ontario, with key differences in scope of practice, core educational requirements and complexity of conditions they assess, treat and manage.

We extend thanks to those who reviewed the document and provided input including physiotherapy academic leaders, the College of Physiotherapists of Ontario, the Canadian Physiotherapy Association and the Ontario Kinesiology Association.

Physiotherapists in Emergency Departments Fact Sheet

OPA’s resource Physiotherapists in Emergency Departments Facts Sheet highlights how physiotherapists help address challenges faced by the health care system. This resource can be used for local advocacy and to help educate decision-makers on the value of physiotherapists in Emergency Departments.

We call on the Minister of Health and health system leaders to:

• Complete the process that began in 2009 as part of Bill 179 to allow physiotherapists to work up to full scope of practice, including ordering diagnostic imaging and laboratory tests;
• Expand adoption of positions/roles for physiotherapists in Emergency Departments across the province; and,
• Expand integration of physiotherapists in primary care and access to community-based physiotherapy programs

OPA previously met with senior leadership at Ontario Health, who is working on innovative solutions to address health system capacity. OPA shared how physiotherapists working up to our full scope of practice in Emergency Departments and other areas, including community-based programs, can help address health system capacity issues and help patients.

We will continue to advocate and communicate these key messages at every opportunity and engage with key stakeholders in this conversation.

Telerehabilitation Report

OPA’s Telerehabilitation in Physiotherapy During COVID-19 Pandemic Survey backgrounder shares key findings of the member survey completed this summer. It will be shared with stakeholders to further dialogue on the implications of telerehabilitation on the physiotherapy profession. The survey examined experiences of physiotherapists implementing telerehabilitation during the COVID-19 pandemic with a focus on activities immediately following the directive to reduce in-person services in the community. Key learnings about the successes and challenges have been examined, along with key considerations and implications that telerehabilitation may have on the profession and how physiotherapy is accessed moving forward.

Bundled Funding Model for Hip and Knee Replacement Surgery (QBP)

The Ministry of Health has introduced a bundled funding payment model for integrated acute to post-acute (including rehab) pathways for multiple procedures or conditions. The bundled care model for unilateral hip or knee replacement patients has moved into full scale implementation with all 56 hospitals across Ontario that perform these surgeries participating for fiscal year 2019/20. The bundled care model will continue to expand to additional procedures. Implementation of bundled pathways for bilateral hip and knee replacement surgery and shoulder surgery across hospitals that have volunteered to participate in the expansion began on April 1, 2019. The Ministry is in consultation with key stakeholders to develop an approach for phased implementation of bundled pathways for stroke and coronary artery bypass graft surgery (CABG). It is suspected that participation in all these models will be mandatory by 2020-2021.

Through this model, the funding follows the patient regardless of where they receive care, including home and community care. The model is based on having one single payment made to the bundle holder (usually a hospital site) who then establishes partnerships to provide needed follow up care, including rehabilitation. Since bundle holders hold all the funding, they are responsible for providing or paying for all post-acute services a patient needs within their bundled course of care. Partnerships can be made with inpatient, outpatient, home-based, and clinic-based care, such as Community Physiotherapy Clinics (CPCs) and private physiotherapy clinics. If a CPC is involved with the partnership, there is no change to CPCs’ existing funding agreements with the Ministry, as bundled care is separate from Episode of Care (EOC) funding.

More information on this model can be found on the Bundled Care website. Additionally, there are many resources available through Health Quality Ontario’s Bundled Care Community of Practice group on Quorum (registration required), which includes FAQs, webinars, and contact information of all bundle holders. It also provides the opportunity for information exchange between those involved with implementing the bundled care model.

New Member Resource

If you have any questions or comments regarding bundled care please contact Gonxhe Kastrati, Policy Analyst.

Member Webinar: Successfully Implementing the Bundled Care Model

This webinar was held on December 18, 2019. The focus was on enhancing opportunities for successful implementation of the bundled care model and developing successful partnerships between physiotherapy providers and bundle holders. Speakers included Paulette Gardiner Millar, PT and Director of Operational Communication & Quality Improvement with pt Health (community PT clinic provider) and Darryl Yardley, PT and Director of Brant Community Healthcare System (bundle holder).

Access the recording

Q&A on Bundled Care Webinar

Advanced Practice Provider in Musculoskeletal Central Intake Model of Care

Background

On October 27, 2017 the former Minister of Health and Long-Term, Dr. Eric Hoskins announced the provincial expansion of a centralized intake, assessment and management model for musculoskeletal (MSK) conditions starting with hip and knee osteoarthritis, and low back. Building on the successful Central Intake Assessment Centre (CIAC) model for hip and knee arthritis, and the Inter-Professional Spine Assessment and Education Clinic (ISAEC), this investment is aimed at providing LHINs with assessment and planning resources to reduce wait times for diagnostic imaging and surgical consultations for MSK conditions.

On December 1, 2017, as part of establishing a centralized model, all LHINs in Ontario received funding for implementing Rapid Access Clinics (RACs) to enable better access to treatment for those experiencing hip, knee and low back pain. This model utilizes physiotherapists and other health care providers to expedite assessment, triage, and access to needed care. Following this, on December 18, 2017, the Ontario Government committed $37 million over the next three years for the expansion of RACs across the province. This will begin with care for hip and knee osteoarthritis and low back pain symptoms.

As of March 31, 2018 seven LHINs across Ontario have implemented a mandatory RAC referral for hip/knee. By the end of 2018/19 fiscal year, all LHINs will have a mandatory centralized pathway for hip/knee osteoarthritis and low back pain through an implemented RAC.

Implementation of this province wide initiative is being supported by Health Quality of Ontario’s program Adopting Research to Improve Care (ARTIC) which has created a series of webinars to assist organizations with implementing the model and to inform applicants of these new interprofessional opportunities. Archived webinars can be accessed here.

More information

Advanced Practice Provider for MSK Rapid Access Clinic (RAC) for Hip and Knee

View the Advanced Practice Provider for hip and knee Role Profile and the Position Description.

As outlined in the position description, an APP in MSK Central Intake, Assessment and Management is typically a physiotherapist registered with the College of Physiotherapists of Ontario. The APP is a leader with advanced knowledge, skills and attitudes enabling them to effectively solve problems and address the needs of the patient with an MSK condition.

MSK Rapid Access Clinic for ISAEC

View the Advanced Practice Provider job descriptions – part time and full time for MSK Rapid Access Clinic for low back pain (ISAEC).

View the Practice Leader job description for MSK Rapid Access Clinic for low back pain (ISAEC).

As outlined in the job descriptions, ISAEC is an innovative model of care providing patients with low back pain assessment, education and evidence-based self-management plans. The ISAEC model of care is being implemented across the LHINs as part of the MSK RAC implementation.

Advanced Practice Provider FAQ

The OPA received very positive responses from our members regarding the emerging Advanced Practice Provider Role within the centralized intake, assessment and management model for hip, knee, and low back musculoskeletal (MSK) conditions. The following FAQ answers member questions  regarding the APP role, qualifications, and the hiring process.

Read the FAQ

If you are a physiotherapist interested in learning more about these opportunities, or if you are an organization looking to hire a physiotherapist for the APP position, please contact Gonxhe Kastrati, Policy Analyst at the Ontario Physiotherapy Association at 416-322-6866 ext.225.

---

Community Based Physiotherapy during the COVID-19 Pandemic Resource

OPA’s resource, Community Based Physiotherapy during the COVID-19 Pandemic, has been updated and broadened to reflect the role that physiotherapists in the home and community sector, including those who work in team-based care models, have in addressing the rehabilitation needs of individuals who are recovering from COVID-19.

This version provides clinical guidance and further describes the different stages of COVID-19, including post-acute COVID-19 and chronic COVID-19, and outlines the residual impairments that some who are recovering from COVID-19 experience over the long term.

OPA Primary Health Care Community of Practice

The Community of Practice (CoP) is a way for PTs in Primary Health Care to pool their knowledge and experiences in this unique practice area. The CoP shares resources, ask questions, collaborates, receives information and updates from OPA as well as provide input into ongoing advocacy work in this sector.

If you are a PT working in Primary Care, and would like to join our community, please contact Amy Hondronicols, Director, Practice, Policy and Member Services.

Are you a physiotherapist working in a primary health care team?

Contact Amy Hondronicols, Director, Practice, Policy and Member Services to learn about available resources and supports, and to connect with other PTs working in primary health care.

More and more, physiotherapists are playing a key role in primary health care teams across the province. Changes to government policy, and the recent investment of 38.3 new full time equivalent physiotherapist positions in primary health care organizations is seeing more Ontarians accessing physiotherapy as part of their interprofessional primary health care. The documents and resources below will help organizations, physiotherapists, and patients better understand the role primary health care physiotherapists play in the Ontario Health System. Primary health care organizations include:

• Aboriginal Health Access Centres (AHAC)
• Community Health Centres (CHC)
• Family Health Teams (FHT)
• Nurse Practitioner Led Clinics (NPLC)

Learn more about the role of Physiotherapists in Primary Health Care

Webinar Series – Physiotherapists in Primary Health Care in Ontario

FOR ORGANIZATIONS

Are you integrating a physiotherapist into your health care team? Our expert panel discusses the evidence and opportunities for primary health physiotherapy services and answers questions about the role physiotherapists play in providing comprehensive community-centred care.

Watch the webinar

Webinar Slide Deck PHC Organisations

FOR PHYSIOTHERAPISTS

Are you interested in pursuing opportunities in a primary health care team? Our expert panel of physiotherapists discusses the evidence and opportunities for primary health physiotherapy services and how physiotherapists can apply their skills from work in other sectors in these exciting new roles.

Watch the webinar

Webinar Slide Deck PHC Physiotherapists

Mock Job Description

This Mock Job Description may be useful in guiding organizations develop their own physiotherapist position for their team. The description is general in nature, recognizing that physiotherapists in Primary Care Teams will be hired for a range of programming and to meet specific needs of the community; additional responsibilities and qualifications may be required.

Sample Interview Questions for Primary Health Care Physiotherapist Position

These Primary Care Sample Interview Questions have been created to assist organizations in adapting their interview tools when interviewing a physiotherapist for a primary health care position. Physiotherapists applying for a primary health care position can also use these questions to help prepare for interviews. Questions are meant to be general so that they can be modified to reflect the specific patient populations, programs and/or services that the physiotherapist will be involved in; not all questions in this document will be applicable to all positions.

For more information please contact Amy Hondronicols, Director, Practice, Policy and Member Services.

Scope of Practice

Many organizations are bringing a physiotherapist onto their team for the very first time. To learn more about the Scope of Practice of physiotherapists in Ontario, please visit the College of Physiotherapists of Ontario. Also available on the website are key statutory and non-statutory College documents, including the Standards for Professional Practice for Physiotherapists. Physiotherapists with additional skills and competencies may perform a number of authorized activities in Ontario. For additional information, read the Essential Competency Profile for Physiotherapists working in Canada.

Community-Based Publicly Funded Physiotherapy Services and other Programs

The OPA has developed LHIN-specific navigation tools for physiotherapists in all sectors to use when assisting patients and families to access publicly funded physiotherapy services and other programs in the community. The tools include brief descriptions and contact information for community-based publicly funded physiotherapy services (including CPCs) as well as other community programming such as wellness programming, funding, and equipment resources.

TIME™  PROGRAM WEBINAR

TIME™ is a group program which increases access to exercise and promotes health and well-being for people with balance and mobility challenges living in the community.  Developed by physiotherapists at Toronto Rehab, the TIME™ program is a unique collaboration between health care and community recreation organizations. Since its initiation in 2007, physiotherapists continue to have an integral role in the TIME™ program through fitness instructor training, mentoring and ongoing program support. View the webinar to learn how TIME™ is an alternative service model building capacity for safe and appropriate exercise in the community. Learn more about the TIME™ Program.

Watch the Webinar