An advanced practice women’s health clinic improves access to conservative management for continence and prolapse

Ms Caitlin Farmer1, Mrs Sally Schwarz1, Mr  Paul  Howat1

1Northern Health, Epping, Australia

 

Aim: To evaluate the effects of introducing an Advanced Practice Women’s Health Clinic on the gynaecology waiting list, patient satisfaction and conversion to surgery rates.

 

Methods: Through a Victorian Government grant, a pilot project was established assessing women on the Gynaecology waiting list with incontinence and prolapse conditions for suitability for a trial of conservative management. Due to significant demand for other Women’s Health physiotherapy services, the Advanced Practice Clinician also performed the conservative management for each patient where indicated. Outcomes of each appointment including discharge or onward referral and subsequent management were recorded for the period of the trial. Patient satisfaction surveys were given to a sample of convenience.

 

Results: From August 2015 until March 2016 (7 months) ninety-two new patients were assessed, of which 46 required conservative management only. Eighteen were managed in conjunction with the gynaecology team, and 12 in conjunction with their local doctor. In total, 298 appointments were offered in the clinic. The average wait time from referral to assessment decreased from 518 days to 60 days over the period of the grant.

Of patients sent to the gynaecology team, 77% went on to surgical intervention, indicating high levels of agreement between the medical and physiotherapy clinicians. All patients surveyed were extremely satisfied with their management in the advanced practice physiotherapy clinic.

 

Significance to Allied Health: Physiotherapy-led women’s health and continence clinics are an important, cost-effective and highly evidence-based method of managing demand for gynaecology services. There are also opportunities to expand the scope of Advanced Practice Women’s Health Physiotherapists further to include areas such as pessary management.