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Higher quality of care in emergency departments with physiotherapy service models

Citation

Strudwick, K and Martin, R and Coombes, F and Bell, A and Martin-Khan, M and Russell, R, Higher quality of care in emergency departments with physiotherapy service models, Emergency Medicine Australasia pp. 1-14. ISSN 1742-6731 (2021) [Refereed Article]

Copyright Statement

2021 Australasian College for Emergency Medicine

DOI: doi:10.1111/1742-6723.13868

Abstract

Objective:To investigate the quality of care provided by EDs with physiotherapy services compared to those without, using established musculoskeletal process and outcome quality indicators (QIs).

Methods: An analysis was undertaken of prospective observational and chart audit data collected from 628 patients who presented with a musculoskeletal injury in any of the eight participating EDs in Queensland in 2016-2017. The care provided was scored against 46 musculoskeletal QIs. Quality of care was first compared between EDs with physiotherapists to EDs with a limited physiotherapy service, and second between EDs with primary contact physiotherapists to EDs without. χ2 and Fisher's exact tests were used to identify significant results.

Results: In the first comparison, EDs with physiotherapists performed significantly higher on 15 QIs and EDs with only limited physiotherapy performed higher on two QIs. In the second comparison, EDs with primary contact physiotherapists performed significantly higher on 17 QIs when compared to EDs without and three QIs demonstrated significance in favour of EDs without primary contact physiotherapists. Performance differences occurred across both process and outcome QIs, including musculoskeletal assessment, diagnostics, pain assessment and management, fracture management, medication safety, mobility, patient information, referrals and follow-up, re-presentations and patient experience.

Conclusions: EDs with physiotherapists provide at least equivalent or higher quality of care for patients with musculoskeletal injuries than those EDs with limited access to physiotherapists. This may be because of their specialised training in musculoskeletal diagnosis and treatment, as well as the impact of teaching and mentoring for other ED clinicians.

Item Details

Item Type:Refereed Article
Keywords:emergency service, hospital, musculoskeletal disease, physiotherapy specialty, quality of healthcare, wound and injury
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Emergency medicine
Objective Division:Health
Objective Group:Evaluation of health and support services
Objective Field:Evaluation of health outcomes
UTAS Author:Martin, R (Ms Romany Martin)
ID Code:148235
Year Published:2021
Deposited By:Health Sciences
Deposited On:2021-12-13
Last Modified:2022-01-14
Downloads:0

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