ORTHOPAEDIC OUTREACH IN NUNAVUT

Prior to 2015, Nunavut patients had to travel twice from their remote communities to Iqaluit, and then to Ottawa in order to undergo a joint replacement; once for an assessment and then again for the surgery. Wait time to assessment was eighteen months and the cost of this was $1700 per patient. In 2015, the Regional Hip and Knee Replacement Program of the Champlain Local Health Integration Network (LHIN) began a traveling Total Joint Assessment Clinic (TJAC) to Iqaluit, Nunavut to reduce wait times, and cost for Nunavut residents with hip and knee arthritis. In 2015 the Regional Hip and Knee Replacement Program of the Champlain Local Health Integration Network (LHIN), in collaboration with Ottawa Health Services Network Inc. (OHSNI) partnered to operate a TJAC in Iqaluit, NU. TJAC is a triage clinic for patients with hip or knee arthritis who are potential Joint Replacement candidates. A TJAC team of one Assessor and one Orthopaedic Surgeon travel to Iqaluit, NU three times per year to perform TJAC assessments for Nunavut elders and residents. Each clinic lasts a week. All patients are seen by the TJAC Physiotherapist assessor, and surgical candidates see the surgeon the same day Average wait time to consult has been reduced from eighteen months to seven months. Per patient cost of TJAC visits have been reduced from $1700 to $500. This collaboration between the Regional Hip and Knee Replacement Program and Ottawa Health Services Network has facilitated a more rapid access to hip and knee replacement surgery for Nunavut resident by reducing wait times significantly. It has also reduced the cost per patient for these services. A Central Intake referral service is currently being discussed in order to improve timely access to the appropriate Orthopaedic service for all orthopaedic conditions at each Orthopaedic clinic in Iqaluit.