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 futureFocus groups with

stakeholders

Canadian certified prosthetists and

orthotists

Survey of Canadian certified prosthetists and orthotists

Referral sources Competing 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

29

46

23

Prosthetist Orthotist Prosthetist/Orthotist

% r

espo

nden

ts

Survey results - employment

25

61

14

Public Private Public & private

% r

espo

nses

Survey results – years employment

6

18

51

7

17

5 or less 10 or less 10 or more other No response

% r

espo

nden

ts

Years of practice

Survey results – expected service demand 3-5years

25

59

16

Remain the same Increase Decrease

% R

espo

nses

Survey results – expected demand 10 years

6

83

9

Remain the same Increase Decrease

% R

espo

nses

Survey results education

63

42

demonstrate tech skills work as technician

% r

espo

nses

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

171 473 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

– 171 473 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)