A physiotherapy-led soft tissue injury review service reduces emergency department length of stay

Ms Caitlin Farmer1, Mr  Jonathon Gill1

1Northern Health, Epping, Australia

 

Aim: To evaluate the effects of introducing a Physiotherapy-Led Soft Tissue Injury review service on ED Key Performance Indicators, as well as staff and patient satisfaction.

 

Methods: Through a Victorian Government grant, a pilot project was established which allowed ED treating clinicians the ability to directly book a review appointment with an Advanced Practice physiotherapist for their patient within an evidence-based timeframe for soft tissue injury management. Data regarding waiting time to appointment, injury type and site, investigations arranged and outcomes was obtained, along with data from ED regarding length of stay and discharge within four hours from ED. The data regarding patients referred to the Soft tissue injury review clinic was compared with patients of similar acuity who were not referred.

 

Results: In the six month period of the project, a total of 348 appointments were booked for the soft tissue clinic, the majority of which were for lower limb injuries. The median wait time to appointment was eight days. Of patients assessed, 49% were referred for ongoing physiotherapy with 11% referred to the Orthopaedic team. Patients referred to the Physiotherapy-Led Soft Tissue Injury Clinic stayed in ED 49 minutes less on average than similar patients who were not referred, and were 2.5 times more likely to be assessed and discharged within four hours. Patient satisfaction was high with 95% of patients very satisfied with their experience.

 

Significance: The introduction of a Physiotherapy-Led Soft Tissue Review Clinic resulted in early outpatient review for patients with soft tissue injuries presenting to the Emergency Department with most patients managed independently. Patients referred to the clinic stayed in ED less time, and were more likely to meet the target timeframes for discharge. Advanced Musculoskeletal Physiotherapy clinics are likely to have impacts beyond the immediate assessment and management of patients and waiting lists.