Strategic thinking for the future of the Prosthetic and Orthotic Profession Nerrolyn Ford BP&O(hons) PhD

The Strategic Process  The movement of the organisation from its history into the future  Challenging of ideas, positions and strategies  Participants thinking often shaped by history and dominant values of the organisation Melin (1998)

Generating strategic plans –Our strategic plans are influenced by recent or vivid events –We consistently underestimate the role of chance and are over optimistic –Strategic plans must be dynamic –Strategic plans must be based upon originality

The strategic planning process Assess External Environment Internal organizational Assessment Strategic direction Define and Select Base Strategy and Contingency Plans Implement Policy/ Strategy Program Evaluate Performance (Fleisher, C. & Bensoussan, B., 2003)

BCIT Visioning Study  Identify trends that are likely to affect the prosthetics and orthotics profession over the next 10 years  Examine how the education/profession will need to change in order to address these trends  Determine numbers of professionals required to meet demands  Identify potential threats and ways to overcome threats

Predicting the future Focus groups with stakeholders Canadian certified prosthetists and orthotists Survey of Canadian certified prosthetists and orthotists Referral sourcesCompeting professions BC Marketing Study

Focus groups -Aims  How is the profession perceived internally, by our referral sources and our competion.  What makes us unique (Strengths)?  What are the potential threats/opportunities for our profession.

Referral sources  Perceived as expensive providers of complex devices that are typically for long term wear  How can P&O’s better meet your needs –Increased emphasis on gait training –More communication with the rehabilitation team –More input in treatment decisions –Provision of continual and constant follow-up –More device design

Competition  Perceive P&O’s as expensive providers of complex devices. –See themselves as specialist providers of devices –Providers of lower cost alternatives –Business people with superior marketing skills

Comparing ourselves to our competition

What we enjoy most about our day to day practice  Competition –Patient education –Patient contact –Problem solving –Biomedical assessment

What we enjoy most about our day to day practice Competition –Patient education –Patient contact –Problem solving –Biomedical assessment Certified P&O’s –Patient education –Patient contact –Problem solving –Working with hands –Designing devices

What we enjoy least about our day to day practice  Competition –Business activities –Administrative work

What we enjoy least about our day to day practice Competition –Business activities –Administrative work Certified P&O’s –Business activities –Administrative work –Marketing

What makes your profession unique? Competition –Hands on/technical skills –Creativity –Problem solving skills –“Try harder”

What makes your profession unique?  Competition –Hands on/technical skills –Creativity –Problem solving skills –“Try harder”  Certified P&O’s –Design and manufacture of complex devices –Knowledge of biomechanics –Problem solving skills –“Try harder”

Key results of focus groups  Discrepancy between internal and external stakeholders regarding the role of the profession  P&O’s failed to identify skills that make them unique from their peers  Need to identify strengths and to improve professional relationship with external stakeholders

Survey results  General information –Personal/employment history –Demographic –Professional trends  Educational –Perceived educational requirements  Clinical –Job skills and requirement –Scope of practice

Survey results - Profession

Survey results - employment

Survey results – years employment Years of practice

Survey results – expected service demand 3-5years

Survey results – expected demand 10 years

Survey results education

Survey results – continuing education  73% believe continuing education needs are not being met  83% felt that a web-based course could serve such a need

Survey results – Important skills  Highly ranked –Design theory –Prosthetic joint design –Clinical research –Marketing –Management skills –Small business skills

Survey results – courses of benefit  Gait training  Clinical outcome measurement  Fracture casting  Sports equipment modification

Key results of survey study  There will be a large increase in demand for P&O services over the next 10 years.  Members have an immediate need for continuing education that is not being met.  Skills in device design, research, business and gait analysis are increasingly important

Marketing studies in P&O  Blocka (1990) – Retirement trends among Canadian P&O’s –Stable until 2008  Nielson (2002) – Effects of aging population on P&O service needs –62% of the population’s orthotic needs and 68% of the population’s prosthetic needs would be met by the year 2005.

BCIT marketing study  Epidemiological review (Duncan, 2001) –Disease incidence and tends –Estimate potential market in Canada  Market review and recommendations (Miller et al 2002) –Workplace statistics –Number of professionals required to meet demand

Epidemiological review  Approximately 40 diseases/conditions were investigated  Incidence rates interpolated to reflect Canadian population (30 million people)  Estimate % of population that may benefit from intervention  Estimated 5% of these will require treatment in any one year.  In BC – (4 million people) there are approximately people that will require treatment each year

BCIT marketing study - results  BC Workplace statistics –Average patients per day Prosthetist – 6 Orthotist – 7.8 –Time to next free booking Prothetists – 4.5 days Orthotists – 11.7 days –Time to deliver device (from initial consultation) Prostheses – 17.2 days Orthoses – 12.5 days –Average hours per week = 44.4

BCIT marketing study - results –Assuming 240 work days per year – patients/7.2 patients per day/240 work days = 100 P&O’s required to satisify market need in BC at the present time. –There are currently 54.

BCIT marketing study  Key findings –There are significant business opportunities for certified P&O’s in the private sector –Need for formal business training –Current workload of clinicians is moderate to heavy –Currently a need for more clinicians in BC

Major Issues arising from Visioning research

In Canada, there has been a radical change in the orthotic marketplace over the past 15 years that orthotists have not responded to.

Major issues  Encroachment (intrång) has become a significant problem  Shortage of certified clinicians  Changes in technology –Lower cost devices –Prefabricated devices –Central fabrication  Poor business and marketing skills

Need to develop a strategy for professional longevity  Involve those affected by the plan  Dynamic – strategy can never stay the same  Clearly defined goals  Original – distinctive competencies  Structure and systems in place  Resources and capabilities

Fluidity in the workforce (S. Raschke)