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Evaluation of performance quality of an advanced scope physiotherapy role in a hospital emergency department

Authors Morris J, Vine K, Grimmer K

Received 30 September 2014

Accepted for publication 20 April 2015

Published 21 July 2015 Volume 2015:6 Pages 191—203


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Editor who approved publication: Dr Robert Howland

J Morris,1 K Vine,1 K Grimmer2

Physiotherapy Department, The Canberra Hospital, Cnr Hindmarsh Dr & Yamba Dr, Garran, ACT, 2International Centre for Allied Health Evidence, University of South Australia, City East Campus, Adelaide, SA, Australia

Background: Physiotherapists working in advanced and extended scope roles internationally make a difference to workflow, performance targets, and patient satisfaction in areas traditionally served by medicine and nursing
Aim: To assess the impact of an advanced scope of practice physiotherapist (ASoP-PT) service in a large Australian hospital emergency department (ED) by measuring national service and triage category indicators, patient and staff satisfaction
Methods: Consecutive patients consulting the ASoP-PT were recruited over 53 weeks following service inception. Descriptions of ASoP-PT activities and patients were collected. Performance was assessed against national ED indicators for length of stay and wait. Patient and staff perspectives were assessed independently by semi-structured interviews. The physiotherapist was formally trained to extended scope of practice including competency in medicines, prescription and application. The legislation prevented him from applying these skills, therefore he worked in an ASoP-PT role in ED
Results: The ASoP-PT treated on average, 72 patients per month in ten shifts per fortnight, consulting patients aged from 1 to 88 years. Patients largely presented with musculoskeletal problems in triage Categories 4 and 5. There were shorter length of wait and length of stay, when the ASoP-PT was on shift. However overall compliance with national performance targets was similar with and without the ASoP-PT. Staff and patient satisfaction was high, particularly valuing the ASoP-PT's expertise in musculoskeletal injuries.
Conclusion: The ASoP-PT performed at least as well as other ED health care providers in meeting national triage targets. Had the legislation permitted his independent prescription of medicines, the ASoP-PT could have worked in an extended scope role, and his performance in meeting targets may have been better.

Keywords: advanced scope physiotherapy practice, emergency department, quality indicators, satisfaction

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