Seeking help to get the full ED picture

 

Macquarie University clinical educator Tina Vickery, APAM, provides a snapshot of a research project aiming to find out more about emergency department physiotherapists.

Over the last 100 years, Australian physiotherapy has advanced from a diploma in massage to a nationally accredited and registered profession, with defined minimum practice thresholds, a robust code of conduct and internationally renowned research programs (Chipchase et al 2006, Physiotherapy Board of Australia 2014, Physiotherapy Board of Australia & Physiotherapy Board of New Zealand 2015).

Physiotherapists now work in a variety of settings such as intensive care, aged care facilities, paediatric units and the emergency department (ED).

The role and scope of physiotherapists has evolved dramatically, moulded by societal, political and economic pressures; emergency physiotherapy more so than most (Nall 2009, Pretorius et al 2016).

In 2010 a small Australian survey found most ED physiotherapists were working in a secondary contact role, still requiring a referral from a doctor (Kilner & Sheppard 2010).

There was a general lack of awareness of their role by other ED staff, bringing into question the utilisation of the ED physiotherapist (Kilner & Sheppard 2010).

Heath Workforce Australia funding led a push for the expansion of ED physiotherapy to primary contact clinicians, bypassing the need for medical practitioner referral, in an attempt to improve efficiency and meet the increasing demand for emergency services (Thompson et al 2014).

While ED physiotherapy is not well understood by patients or other staff, it has a valuable role to play in reducing patient wait times and improving length of stay without adverse patient outcomes (Barrett & Terry 2018, Kilner 2011, Matifat et al 2019).

However, despite a recent APA report supporting the economic value of ED physiotherapists, systematic reviews continue to show the need for robust, methodologically sound research into the scope and role of ED physiotherapists (Desmeules et al 2012, Ferreira et al 2019, Saxon et al 2014).

Aims

Research being conducted as a part of my Master of Research award, in conjunction with Dr Lindsey Brett and Associate Professor Taryn Jones from Macquarie University, aims to establish an accurate picture of ED physiotherapists across Australia, providing comprehensive workforce data including ED physiotherapists demographics, current scope of practice, and experiences in ED.

The study aims to also provide insight into physiotherapists’ perceptions on their current responsibilities and optimisation of ED physiotherapy into the future.

Methods

The study will collect data from Ahpra-registered physiotherapists currently working in an Australian ED through online survey platform REDCap.

It was granted ethical approval by the Macquarie University Human Research Ethics Committee (Reference No: 5202090921827, Project ID: 9098).

The anonymous survey was created with the assistance of an expert panel, and rigorously piloted prior to launch, containing a combination of multiple choice and short answer questions.

The survey is currently open, and will remain open until 10 July 2021.

Future impact

Data from this study could be used to support ED workforce planning and provide further clarification of the physiotherapist’s role within hospital and national delineation documents.

This will help to raise the profile of the physiotherapist in the ED setting and lead to a better understanding of their role by the wider community.

The findings from this study would also benefit physiotherapists through informing advocacy into legislative change and policy development required to enhance the role and training of physiotherapy within the ED.

How to participate

If you are an Ahpra-registered physiotherapist currently working in an Australian ED and are willing to participate in this research, click here for further information and to take part in the survey. The survey will take approximately 15 minutes to complete.

References

Barrett, R., & Terry, L. (2018). Patients’ and healthcare professionals’ experiences and perceptions of physiotherapy services in the emergency department: a qualitative systematic review. International Journal of Emergency Medicine, 11(1), 1-1. doi:10.1186/s12245-018-0201-z

Chipchase, L. S., Galley, P., Jull, G., McMeeken, J. M., Refshauge, K., Nayler, M., & Wright, A. (2006). Looking back at 100 years of physiotherapy education in Australia. Australian Journal of Physiotherapy, 52(1), 3-7. doi:10.1016/S0004-9514(06)70055-1

Desmeules, F., Roy, J.-S., MacDermid, J. C., Champagne, F., Hinse, O., & Woodhouse, L. J. (2012). Advanced practice physiotherapy in patients with musculoskeletal disorders: a systematic review. BMC musculoskeletal disorders, 13(1), 107.

Ferreira, G. E., Traeger, A. C., & Maher, C. G. (2019). Review article: A scoping review of physiotherapists in the adult emergency department. Emergency Medicine Australasia, 31(1), 43-57. doi:10.1111/1742-6723.12987

Kilner, E. (2011). What evidence is there that a physiotherapy service in the emergency department improves health outcomes? A systematic review. Journal of Health Services Research & Policy, 16(1), 51-58. doi:10.1258/jhsrp.2010.009129

Kilner, E., & Sheppard, L. (2010). The ‘lone ranger’: a descriptive study of physiotherapy practice in Australian emergency departments. Physiotherapy, 96(3), 248-256. doi:10.1016/j.physio.2010.01.002

Matifat, E., Méquignon, M., Cunningham, C., Blake, C., Fennelly, O., & Desmeules, F. (2019). Benefits of Musculoskeletal Physical Therapy in Emergency Departments: A Systematic Review. Physical Therapy, 99(9), 1150-1166. doi:10.1093/ptj/pzz082

Nall, C. (2009). Primary care physiotherapy in the Emergency Department. Australian Journal of Physiotherapy, 55(1), 70-70. doi:http://dx.doi.org/10.1016/S0004-9514(09)70072-8

Physiotherapy Board of Australia. (2014). Code of Conduct for registered health practitioners. Retrieved from

Physiotherapy Board of Australia, & Physiotherapy Board of New Zealand. (2015). Physiotherapy practice thresholds in Australia and Aotearoa New Zealand. Retrieved from

Pretorius, A., Karunaratne, N., & Fehring, S. (2016). Australian physiotherapy workforce at a glance: a narrative review. Australian Health Review, 40(4), 438-442. doi:https://doi.org/10.1071/AH15114

Saxon, R. L., Gray, M. A., & Oprescu, F. I. (2014). Extended roles for allied health professionals: an updated systematic review of the evidence. J Multidiscip Healthc, 7, 479-488. doi:10.2147/JMDH.S66746

Thompson, C., Williams, K., Morris, D., Bird, S., Kobel, C., Andersen, P., . . . Masso, M. (2014). HWA Expanded Scopes of Practice program evaluation: Physiotherapists in the Emergency Department sub-projec:t final report. Retrieved from

 

 

 

 

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