What is TJAC?
The Total Joint Assessment Centre (TJAC) is a centre of excellence designed to shorten wait times for total joint, hip and knee replacement surgery.  With initial funding through the Government of Ontario’s Wait Time Strategy program, the project is a joint effort between Markham Stouffville Hospital, York Central Hospital and North York General Hospital.  TJAC’s goal is to reduce wait time for patients needing hip or knee replacement, for both consultation and surgery, by offering all surgical candidates a surgery date within 26 weeks of their referral to the Centre.  This period is consistent with the provincial access targets set out by the Ontario Government in December 2005 as well as other time periods across Canada. 

The patient benefits
The ultimate goal is to improve the patient’s quality of life and promote better patient management care processes. Referrals to the Centre must be made by a physician or a family doctor.  Participating hospitals are equipped with a team of orthopaedic surgeons, administrators and clinicians.  Patients will be able to:

• get early consultation and testing;
• choose the date on which to have their surgery; and
• choose the first available surgeon from one of  the three partner hospitals; or
• opt to wait for a select surgeon at their preferred hospital anywhere in Ontario.

Assessment of the patient
A patient should receive an appointment with TJAC within two weeks of their referral. On the first visit, the patient will be assessed by a clinician who is an experienced orthopaedic nurse, nurse practitioner or physiotherapist.  A comprehensive assessment includes physical, social and lifestyle status.  Patients who are identified as surgical candidates will return in 2 to 3 weeks for a second visit with an orthopaedic surgeon. 

Options to surgery
In the case where a patient is not ready or willing to have surgery, there are treatment options available to improve their condition.  A care plan will be developed to help the patient and their physician or family doctor to manage their condition (e.g. pain control, weight management), and to maintain or improve their level of functioning and overall health status.  Many factors can affect a patient’s willingness to have surgery, such as living circumstances, employment status, age, other health conditions and support from family, friends and their community.  In the case where a patient decides not to go on to surgery, the other options will provide them with the best care possible.