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Impact of Physiotherapy Care in the Emergency Department

Westmead Hospital
Project Added:
30 October 2014
Last updated:
30 October 2014

The impact of the Emergency Physiotherapy Practitioner on Emergency Department care for patients with Musculoskeletal Injuries.

Summary

This study will pool data from multiple sites to quantitatively demonstrate the relative efficiency of physiotherapy service compared with the usual care provides for patients presenting to ED with musculoskeletal conditions (triage category 3-5). The study will compare waiting times and overall length of stay for patients presenting to ED with an isolated musculoskeletal injury treated by the physiotherapy practitioner and this data will be compared to the treatment provided by usual care providers to determine if there is a value add from this service. Secondary measures will include patient satisfaction of advice given and satisfaction of the emergency staff with the physiotherapy practitioner. Data will be collected on the duties that the practitioner carries out during their working day and will be recorded in percentages of clinical versus non clinical workloads.

Aims

  • To review the impact of the Emergency Physiotherapy Practitioner (EPP) on wait times and length of stay for patients who present with a Musculoskeletal Injury and to determine if there is any value add from this service compared to the usual care provided.
  • To determine both patient and staff satisfaction of the ED Physiotherapy service across multiple hospital sites.
  • To evaluate the role of the emergency physiotherapist across multiple sites and to determine time spent in a clinical role compared to non-clinical.

Benefits

Improving patient flow and reduced waiting times is an important objective of health providers to help cope with the increasing number of presentations to emergency departments. Physiotherapists have the specialized knowledge and skills to treat this patient population, and hence the addition of physiotherapists to the ED allows emergency medical staff to attend to more urgent cases.

Physiotherapy services are being used to a greater extent in EDs and ED musculoskeletal physiotherapy work has only been reported at single sites which has shown to provide benefits such as reduced waiting times, reduced length of stay and improved patient satisfaction. There has been no research conducted in Australia to date that has involved comparison of data across multiple sites.

Project status

Project status: Implementation.

Project started: 1 January 2013.

A trial of the data collection has commenced at the lead site to determine accuracy of data collection prior to implementation at all other sites.

The project is designed to evaluate the impact of early physiotherapy intervention. Official evaluation of this service has not commenced as final ethics approval is pending.

Implementation

The lead site and pilot site for this project is Westmead Hospital. This project will be implemented at 20 hospitals across NSW.

This project has been funded by the Emergency Care Institute.

This project was presented at the ECI symposium in November 2013.

Information about the project was published in the Australian Physiotherapy Association Monthly Journal “InMotion” in June 2014.

Background

Improving patient flow and reduced waiting times is an important objective of health providers. Physiotherapists have the specialized knowledge and skills to treat some ED patients with isolated musculoskeletal injuries, and hence the addition of physiotherapists to the ED has potential to allow emergency medical staff to attend to more urgent cases. Anecdotal evidence exists for ED Physiotherapy services being used to manage a broader range of patients and ED physiotherapy work has reported such benefits as reduced waiting times, reduced length of stay and improved patient satisfaction. However the evidence has not been examined across multiple sites in the NSW health system. There is some evidence reporting an ED physiotherapy service results in improved patient satisfaction and outcomes in the short term, but again no research conducted in Australia to date that has involved comparison of data across multiple sites. It is unclear whether specific physiotherapy skills help address ED service delivery across multiple sites, and there is limited evidence investigating primary contact physiotherapists managing musculoskeletal patient population compared to management solely by a usual care provider.

There is limited data on emergency staffs’ satisfaction with the EPP role within ED and whether the role has had an impact on care provided by usual care providers in ED.

To date there is no reported information to describe the types of treatment and other roles performed by the EPP in ED.

All EPP will be asked to keep a record of the types of treatments they perform with each of the patients they see. A standardised form for recording this information will be provided. This paper record of activities will then be stored on a spreadsheet to allow for easier analysis at the end of the data collection period which will be a one month period at an allocated time.

Contact

Katherine MakaSenior Musculoskeletal Physiotherapist
Westmead Hospital, Western Sydney Local Health District
Phone: 02 9845 6500
Email: Katherine.maka@health.nsw.gov.au

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