Impact of the primary contact physiotherapy practitioner role on emergency department care for patients with musculoskeletal injuries in New South Wales

Abstract

Objectives To determine the impact of the emergency physiotherapy service provided through different models of care on service quality indicators, patient flow, staff and patient satisfaction. Method A mixed method prospective observation study was conducted between September 2014 and April 2015 in 19 EDs where a physiotherapy service is provided. Results Patients seen by the primary contact physiotherapist (PCP) were associated with a significant reduction in ED length of stay by 108 min, wait time to treatment by 10 min (n = 4 EDs) and time‐to‐first analgesia by 18 min (n = 19 EDs) compared to those seen through usual care processes. Patients who received care by a doctor first and then physiotherapist (secondary contact model) had a prolonged length of stay compared to other care pathways. High levels of satisfaction with the PCP role were expressed by ED staff (n = 17 EDs) and patients (n = 19 EDs). More than 95% of patients who received care by PCP were satisfied with the management of their condition, understood the advice and discharge information provided and had enough time to ask questions. Conclusion ED implementation of the PCP model may improve patient flow and efficiency of clinical skill utilisation in a complex, high demand workplace.

Core competencies for first contact physiotherapists in a direct access model of care for adults with musculoskeletal disorders: A scoping review

“…Twenty articles used quantitative methodologies, such as cohort, cross‐sectional, and randomized or non‐randomized, controlled designs (Addley et al., 2010; Bishop et al., 2017; Bornhöft et al., 2019; Childs et al., 2005; Domholdt & Durchholz, 1992; Donato et al., 2004; Durant et al., 1989; Gagnon et al., 2021; Gorman et al., 2010; Holdsworth et al., 2007; Jette et al., 2006; Keller et al., 2022; Kilner & Sheppard, 2010; Ludvigsson & Enthoven, 2012; Mitchell & de Lissovoy, 1997; Nordeman et al., 2006; Onyeso et al., 2022; Overman et al., 1988a; Richardson, 2005; Taylor et al., 2011); 9 used qualitative methodologies based on interviews, focus groups, or Delphi methods (Alshareef et al., 2023; Boakye et al., 2016; Burley et al., 2020; Chance‐Larsen et al., 2019; French & Galvin, 2017; Kumar & Grimmer, 2005; Lefmann & Sheppard, 2014; McMahon et al., 2016; Vader et al., 2022); 2 used a mixed methodology (Alkhouri et al., 2020; Fisher, 2020); seven involved knowledge syntheses such as systematic, scoping, critical, and narrative reviews (Boakye et al., 2016; Ferreira et al., 2019; Foster et al., 2012; C. Harris et al., 2020; Lackenbauer et al., 2017; Lin et al., 2020; Ojha et al., 2014); 9 were viewpoints (editorials and clinical commentaries) (Bishop et al., 2013; W. G. Boissonnault et al., 2010; W. G. Boissonnault & Ross, 2012; W. Boissonnault & Goodman, 2006; Crane & Delany, 2013; Fleming‐McDonnell et al., 2010; Juneja et al., 2020; Lebec & Jogodka, 2009; McMahon et al., 2016); and 18 were from grey literature, including international references, books, and theses (APTA, 2012, 2...…”

Barriers and facilitators to guideline-recommended care of benign paroxysmal positional vertigo in the ED: a qualitative study using the theoretical domains framework

“…The introduction of musculoskeletal physiotherapists in ED to improve patient flow has freed up medical staff to see higher acuity patients27 while positively impacting waiting times and length of stay 28 29. BPPV is not life-threatening, and once a serious cause has been ruled out, the patient may be considered a lower priority which can be assigned to another discipline with clinical expertise such as physiotherapy 6 30.…”

Analysis of recent Australasian Sonographers Association (ASA) conference abstracts: How many progress to publication?

“…Similar findings were reported with an increase from 18.2% to 21.5% when data analysed only 2 months after the current year's 2019 ANZSNM conference was excluded 30 . Other studies have utilised more than 5 years of conference data, 25,35 or completed analysis over 5 years or more affecting the reported publication rate 16,22,34 . A small number of studies included publications in languages other than English identifying more papers, impacting the conference abstract to publication rates 16,22‐23,25 .…”