Musculoskeletal triage: a mixed methods study, integrating systematic review with expert and patient perspectives

A review of the surgical conversion rate and independent management of spinal extended scope practitioners in a secondary care setting

“…6,14 This results in the perception that ESPs are better placed to manage the vast majority of non-surgical cases in a spinal unit. 5,9 Our study demonstrates a high surgical yield of patients discussed with surgeons for surgical consideration; 81% of patients referred for surgical consideration were confirmed to be suitable for surgery. This is in accordance with the findings of Burn and Beeson,4 who demonstrated a surgical conversion rate of 75%, while Bath et al found a rate of 80% 5 and…”

“…13 Paper triage and orthopaedic triage have both been instigated in the NHS as a means to improve patient function and symptoms, and to reduce waiting times by allowing the majority of non-surgical patients to be reviewed by a non-surgical specialist. 9 ESPs have been shown anecdotally to be in diagnostic agreement with surgeons and have traditionally provided a more holistic approach of management for patients, irrespective of whether they are surgical candidates. 6,14 This results in the perception that ESPs are better placed to manage the vast majority of non-surgical cases in a spinal unit.…”

An evaluation of diagnostic agreement rates between advanced practice physiotherapists and paediatric orthopaedic consultants for children with musculoskeletal complaints

“…Orthopaedic triage utilizes a screening approach to identify the most appropriate care pathway for patients, thereby reducing waiting times for patients (Morris, James, Davey, & Waddington, ). Recommendations are that orthopaedic triage clinics should be staffed predominantly by physiotherapists, with auxiliary support from the consultant team (Joseph, Morrissey, Abdur‐Rahman, Hussenbux, & Barton, ).…”

“…As APPs are often responsible for a patient's complete episode of care, it is essential that they demonstrate excellent clinical reasoning and diagnostic skills. The wide variability in the triage role, both from centre to centre and within national healthcare systems, has been consistently identified (Desmeules et al, ; Joseph et al, ; Morris et al, ; Oakley & Shacklady, ; Saxon, Gray, & Oprescu, ), thus necessitating research to be completed within individual systems (Stanhope, Grimmer‐Somers, Milanese, Kumar, & Morris, ).…”

Patient‐reported outcome measures in advanced musculoskeletal physiotherapy practice: a systematic review

“…This need for more consistency in quality assessment has been recognized and advocated for in APP research (Joseph, Morrissey, Abdur-Rahman, Hussenbux, & Barton, 2014;Morris, James, Davey, & Waddington, 2015), and, coupled with the lack of patient-centred outcomes, demonstrates the necessity to explore PROMs being utilized by APPs. Previous systematic reviews of outcome measures in MSK practice have been specific to body regions and/or disorders (Chapman et al, 2011;Kalyoncu, Dougados, Daures, & Gossec, 2009;Litcher-Kelly, Martino, Broderick, & Stone, 2007;Kearney, Achten, Lamb, Plant, & Costa, 2012;Page et al, 2015;Ramkumar, Harris, & Noble, 2015;Shultz et al, 2013;Walmsley, Williams, Ravey, & Graham, 2010), but as APPs commonly assess a variety of MSK disorders, a systematic review to identify the PROMs utilized across all MSK disorders reviewed by the physiotherapists, is required.…”