Advanced practice women’s health and continence

Ms Robyn Brennen1

1Monash Health, Cheltenham, Australia

Aim:

In 2014 and 2015, Monash Health and Barwon Health implemented the first public advanced practice physiotherapy services in continence and women’s health in Australia, aiming to increase:

  • Timely access to evidence-based best-practice care
  • Workforce integration and collaboration
  • Satisfaction of patients with the management of their pelvic floor dysfunction

Method:

Patients referred to the Urogynaecology Clinic with incontinence or mild-moderate pelvic organ prolapse, were offered an appointment in the advanced practice physiotherapy clinic. After initial assessment, the physiotherapist made referrals for medical review and/or ongoing physiotherapy or could discharge the patient according to set criteria.

Data was collected on waitlists and waiting times, patient and staff satisfaction, clinical presentations and management, and cost-effectiveness, from December 2014-December 2015, with analysis conducted by PriceWaterhouse Coopers in January 2016.

Results:

External evaluation found:

  • 40%-50% reduction in time and cost per occasion of service,
  • 58% improvement in meeting best-practice guidelines, with patients receiving timely non-surgical intervention instead of, or prior to, invasive procedures,
  • 100% patient agreement with clinical care and decision-making
  • No adverse events

Six advanced practice physiotherapy in continence and women’s health competency and credentialing packages were developed, due to be published on the Victorian DHHS website in December 2016.

Significance of the findings to allied health:

Advanced practice continence and women’s health physiotherapy roles contribute to a streamlined, cost-efficient service, consistent with best-practice guidelines.

Through competency-based assessment, allied health professionals can demonstrate their clinical excellence and ability to meet patient needs in the face of medical workforce shortages.