Arthritis clinics offer education, management

Kaiser Permanente Mid-Atlantic Region uses its arthritis clinics to deliver patient education and peer support in a timely and cost- effective manner. Although there are more than 100 types of arthritis, the clinics focus on the three most prevalent in the managed care organization’s (MCO) arthritis population.

"We are focusing on rheumatoid arthritis, osteoarthritis, and fibromyalgia, and we run separate clinics about every two months for each group," says Joyce E. Graham, RN, BSN, rheumatology case manager for the organization’s West End Medical Center in Washington, DC. The patient cooperative clinic concept brings patients, health care professionals, social workers, and trained patient volunteers together to discuss all aspects of disease management, Graham says. (For more information on patient volunteers, see story, p. 70.)

Clinics are run like workshops, combining education, hands-on demonstrations, and peer support. "One workshop we did was on joint preservation and physical therapy. We had discussion from the patient volunteer and a physical therapist. Then the therapist led everyone through a simple exercise routine," she says.

Graham is charged with setting up and organizing each clinic. "I start by putting together a roster of appropriate patients and contacting them." Her other duties include:

• organizing a packet of educational materials in folders for both patients and attending clinicians;

• contacting clinicians to confirm their participation;

• providing clinicians with an agenda for the clinic;

• confirming patient attendance;

• registering patients as they arrive;

• collecting patient evaluations at the end of each clinic.

"I’m also an ongoing resource for our arthritis patients," Graham says. "Patients call me when they need medication refills. They call me with complaints. If they’re having trouble getting an appointment, I get the schedule and help fit them in to see the rheumatologist. Patients also call me for their lab results or with a variety of other concerns.

"Sometimes patients just need someone to talk to, and that’s me." she says. "Especially patients who have been here awhile. They used to call for advice and get someone who would pass on a message to the doctor. Now, they call me, and they feel more secure that they’re talking to someone who understands their condition. It’s made a difference. The combination of the clinics and my availability as a resource, has really helped improve patient satisfaction."