As a result of the continuing challenges facing the healthcare sector in South Africa, Mediclinic Winelands Orthopaedic Hospital in partnership with the Institute of Orthopaedics and Rheumatology (IOR) are together creating a specialised centre, that will offer greater expertise, training opportunities as well as improved and highly specialised care being delivered to patients.

Currently, the risk lies in that many existing South African specialists work independently from their peers scrutiny. This may result in un-checked practices without effective outcome measurement strategies and sharing of data, especially that of complications and negative short and long term outcomes.

Specialist training programmes in South Africa currently focus largely on the provision of basic specialist discipline care, resulting in a lack of super-specialist level training. This may result in higher complication and surgical revision rates in elective surgical intervention. In addition to this, South African patients are often under the impression that they need to travel abroad for high-level specialist care. Mediclinic Winelands and IOR are offering a convenient and highly specialised solution.

Mediclinic Winelands Orthopaedic Hospital will provide the platform for world-class South African specialists and key-opinion leaders to practice musculoskeletal medicine to the highest possible level and quality of care. It will also function as a research and training facility both for local specialists and from around the globe through fellowship programs, Registrar rotation and ‘shorter visiting fellow’ as well as the training of highly skilled theatre and ward staff.

The Scope
The Institute of Orthopaedics and Rheumatology is to be a Specialist Institute based at Mediclinic Winelands Orthopaedic Hospital, dedicated to surgical and medical management as well as rehabilitation of non-emergency musculoskeletal conditions, at the highest possible level. The unit is to function as the “tip of the sword” in terms of innovation and capabilities, able to compete in the global arena of specialist musculoskeletal surgery and care. This is affected through attachment of individual surgeons and specialists, deemed countrywide / world-wide, as key opinion leaders and the frontrunners in their various fields.

Institution reputation and quality of patient care, as well as outcomes are the most important measures of success for the IOR. This correlates to the core Mediclinic focus of placing patients at the centre of all decisions and driving value through improved clinical outcomes and patient experience. Ownership and pride in the quality of care will be a key factor for all medical personal involved.

At the heart of one of South Africa’s best-known university towns, Mediclinic Winelands Orthopaedic Hospital and the IOR will function in close proximity-, and with a well-established relationship with Stellenbosch University and Tygerberg Academic hospital and the Stellenbosch Academy of Sports (SAS).

With teaching set as one of the fundamental principles in the establishment of the IOR, facilities that allow hosting of academic events and training are integral. IOR is to serve as a training facility for the best and brightest in our young medical professionals in the field of Orthopaedic surgery, Rheumatology and Musculoskeletal Radiology and Anaesthesiology. Additional skill advancement will be provided for nursing staff and rehabilitation personal with privately funded training in these fields.

A multi-disciplinary approach to all patients, involving all stakeholders from the outset of treatment (all members of the team working in the same centre and in close proximity) allows for more detailed treatment planning and supports an improved outcome. Surgeons meeting with Anaesthetists, Physician Rheumatologists, Nursing staff, rehabilitation personal and case-managers, prior to undertaking a surgical procedure, will greatly improve cohesion in efforts and insights into specific problems that might arise. This together with an informed position on the individual patient’s social support structures would greatly contribute to successful treatment.

Emphasis is placed on cost effectiveness in dealing with tertiary level pathology, not catered for elsewhere, as IOR from inception, positions itself to deal with complex pathology - currently catered for by non-specialised centres. Most hospitals in the South African private sector are only equipped for level two pathology - making it more difficult to deal with more complex cases, if and when they do arise.

In limiting the pathologies catered for by the hospital to Orthopaedic-specific conditions, we allow for uniform use of medication and consumables by all the doctors involved. This dramatically decreases the requirements in terms of scope and variety of drugs and consumables that need to be stocked.

Innovation and development through co-operation with the local engineering and bio-engineering facilities are strongly encouraged, and the involved surgeons and clinicians in the IOR project are expected to participate actively in on-going research, regular publication in peer review journals, podium presentations as well as development of novel technologies. A post-doc research consultant has been employed to facilitate and co-ordinate all research and data capture. Data capturing and analysis as well as quality control is to be enshrined in the daily processes of IOR in order to actively contribute to medical science research and monitor outcomes.

Charity and laying the foundation to Private / Public clinical collaboration
IOR has initiated a section 18A fund; Joint Venture Trust, which supports pro bono surgery for qualifying patients selected by Tygerberg Hospital who require specialist orthopaedic surgery.

Not only does this underscore our already existing academic relationship with Stellenbosch University, it also creates a pathway to accommodate future NHI mechanisms of interaction.

We also assist selected local sportsmen/women without funds or not on medical aid through above fund.

A second section 18A fund for academic ventures of all members is currently being established. No direct industry sponsorship will be entertained for any members, only via the academic fund with independent trustees determining the validity of the request.