Stephen D Gill, BPhty, PhD, Senior Clinician Physiotherapist; Julian Stella, MBBS, FACEM, Staff Specialist.
Implementation and performance evaluation of an emergency department primary practitioner physiotherapy service for patients with musculoskeletal conditions
Article first published online: 9 OCT 2013
© 2013 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine
Emergency Medicine Australasia
Volume 25, Issue 6, pages 558–564, December 2013
How to Cite
Gill, S. D. and Stella, J. (2013), Implementation and performance evaluation of an emergency department primary practitioner physiotherapy service for patients with musculoskeletal conditions. Emergency Medicine Australasia, 25: 558–564. doi: 10.1111/1742-6723.12134
- Issue published online: 5 DEC 2013
- Article first published online: 9 OCT 2013
- Manuscript Accepted: 28 AUG 2013
- emergency service;
- healthcare reform;
- physical therapist
The study aims to describe the implementation of a primary practitioner physiotherapy service within a large regional ED and to evaluate its impact on waiting time and length of stay.
Integration and scope of practice of the physiotherapy service within the ED were described. Retrospective analysis of waiting time and length of stay data for the 3 years, 1 October 2008 to 30 September 2011, was performed. The performance of the physiotherapy service was compared with the Australasian College for Emergency Medicine (ACEM) waiting time guidelines, the Victorian Department of Health length of stay targets and to a similar group of patients seen by medical staff.
The primary practitioner physiotherapy service saw 5641 patients of which 33% were less than 18 years old. The most common presentations seen by the service were limb fractures, soft tissue injuries and low back pain. Ninety-two per cent of patients were seen within the ACEM waiting time guidelines, and 91% of patients who went home were discharged within 4 h. Non-randomised comparisons with similar patients seen by medical staff indicated that patients seen by the physiotherapy practitioner service had shorter waiting times and length of stay.
The current study found that patients with musculoskeletal problems seen by a primary practitioner physiotherapy service had improved waiting times and length of stay relative to ACEM and Victorian Department of Health targets, and though constrained by a retrospective non-randomised design, to a similar group of patients seen by medical staff. Further evaluation of the physiotherapy practitioner service is required.