Evaluation of a novel and innovative physiotherapy service in the Emergency Department at Epworth Richmond.

Abstract

INTRODUCTION: This project is a descriptive evaluation of a pilot physiotherapy service in the Emergency Department (ED) at Epworth Richmond. BACKGROUND: With patient care in the Richmond ED largely provided by medical and nursing staff, the opportunity was identified for more comprehensive care of patients presenting with falls and/or musculoskeletal injuries in-line with best available evidence. Based on external benchmarking and extensive modelling, a pilot of the first known dedicated physiotherapy service in a private ED in Victoria commenced in April 2016 at Epworth Richmond. METHOD: Support by an Epworth Medical Foundation Scholarship, this service evaluation is based upon the provision of the Richmond ED physiotherapy service on 20th April 2016 until 27th December 2016. Evaluation included patient satisfaction surveys, staff (nursing and medical) satisfaction surveys, analysis of referrals from ED medical staff (e.g. number, presentation type, time seen & clinical coverage) and service analysis (e.g. physiotherapy modalities used and rehabilitation referral patterns). RESULTS: This review of the ED physiotherapy service has demonstrated outstanding feedback on both patient (99%, n=25) and staff (99%, n=23) satisfaction surveys; clinical coverage (% referrals attended) of 99%; growing numbers of referrals overall (average 4.2/shift); reasonable spread of referrals with greatest numbers on weekends and Mondays; good distribution of referrals across working hours and proactive discharge planning. CONCLUSION: Since its commencement in April 2016, the Richmond ED physiotherapy service has established itself as a significant enhancement to the care of patients presenting with musculoskeletal injuries and falls. This evaluation has clearly demonstrated a sustained and growing clinical demand for the service, the added values of a range of modalities provided by a dedicated physiotherapy service and high levels of satisfaction from patients, nurses and doctors. The pilot service has now evolved to a permanent weekday service, with a future goal to include permanent weekday and public holidays.