Escalation system
Patients that use the moveUP App (Therapy) will be monitored and coached daily by physiotherapists via the moveUP care platform (this is what we call “first line”). Clinical activities that do not fall within the scope of the physiotherapists’ professional competence will be flagged for 2nd line review in the moveUP care platform and thereby referred to the orthopaedic consultant for example.
2nd line escalation
The allocated 2nd line medical professional(s) will log in daily to the moveUP care platform to give appropriate advice to those referred patients. If used on a daily basis, this constitutes less than 5% of active patients.
The following postoperative issues will always be escalated to the 2nd line by the treating physiotherapist:
- Signs of DVT (persistent pain, strained calf, increase in swelling, warmth, white or blue discolouration)
- Fever > 38°C
- Postoperative nausea > 3d
- Pain during the night for 3 consecutive nights (possible sign of inflammation)
- Sudden pain or complaint after a wrong movement
- Fall incident
- Mobility:
- Knee:
- Not being able to fully extend the knee
- No progress of mobility
- ROM < 90° beyond 6/52
- Hip:
- < week 6: No Hip flexion >90°
- Knee:
3rd line escalation
If the 2nd line medical professional judges it necessary, he can escalate to the treating surgeon (3rd line). In addition, the surgeon can indicate particular issues or concerns which he would always want to be notified about by using the medical protocol form below.
In any case, the treating surgeon will receive an account to log into the moveUP care platform.
Protocols
At moveUP we developed certain protocols our physiotherapists work by. They were developed based on expert opinion and literature. In your medical protocol form, you can choose to comply with them or provide your own protocol(s).
Protocol antithrombotic prophylaxis
Your hospital’s medical protocol
Before starting a new implementation with a hospital we always ask one of the surgeons to fill out the medical protocol form. This way the physiotherapist who is tasked with the digital patient follow-up can guide the patient according to your chosen protocol, ensuring consistency in advice given along the patient pathway. In addition, you can indicate in which particular situations you want to be notified.