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20-11-2023 | Triage | Original Article

An evaluation of the effectiveness of an advanced practice physiotherapist in the emergency department setting in Ireland

Authors: David Howland, Gráinne Cunniffe, Seamus Morris, Paul Staunton

Published in: Irish Journal of Medical Science (1971 -)

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Abstract

Background

One of the means of easing increased pressure on emergency care worldwide has been the development of advanced musculoskeletal physiotherapy practice in the emergency department setting. This model of care is in its infancy in Ireland.

Aims

To evaluate the effectiveness of an advanced practice physiotherapist working as a primary contact clinician in the emergency department at St. James’s Hospital, Dublin.

Methods

A three-month retrospective chart review was undertaken for patients assigned the advanced practice physiotherapist as their primary clinician during their emergency department attendance. Three widely accepted measures of quality in emergency medicine were used to evaluate effectiveness, namely, time from attendance to discharge, time from triage to assessment, and unplanned reattendance within seven days.

Results

A total of 129 patients were included in this study. Time from attendance to discharge was significantly less in the APP group (mean 208.5 min, standard deviation 122.4 min) than in the ED group (mean 377.1 min, standard deviation 314.7 min) (mean difference − 168.61 (95% C.I − 191.24– − 145.98)) (p < 0.001). Time from triage to assessment was significantly less in the APP group (mean 72.1 min, standard deviation 51.9 min) than in the ED group (mean 94.1 min, standard deviation 96.5 min) (mean difference − 22.08 (95% C.I − 31.28– − 12.89)) (p < 0.001). The unplanned reattendance rate was 3.9%. No adverse events were identified.

Conclusions

The findings of this study indicate that an advanced practice physiotherapist can provide a timely, effective, and safe service for patients attending the emergency department with musculoskeletal complaints in Ireland.
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Metadata
Title
An evaluation of the effectiveness of an advanced practice physiotherapist in the emergency department setting in Ireland
Authors
David Howland
Gráinne Cunniffe
Seamus Morris
Paul Staunton
Publication date
20-11-2023
Publisher
Springer International Publishing
Keyword
Triage
Published in
Irish Journal of Medical Science (1971 -)
Print ISSN: 0021-1265
Electronic ISSN: 1863-4362
DOI
https://doi.org/10.1007/s11845-023-03567-4