Orna Fennelly1, Catherine Blake1, Oliver FitzGerald2, Roisin Breen3, Cliona O'Sullivan1, Marie O'Mir4, François Desmeules5, Caitriona Cunningham1. 1. School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland. 2. Department of Rheumatology, St Vincent's University Hospital, Dublin, Ireland. 3. Health Service Executive, Dublin, Ireland. 4. Physiotherapy Department, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland. 5. School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada.
Abstract
BACKGROUND: Since 2011, advanced practice physiotherapists (APPs) have triaged the care of patients awaiting orthopaedic and rheumatology consultant/specialist doctor appointments in Ireland. APP services have evolved across the major hospitals (n = 16) and, after 5 years, profiling and evaluation of APP services was warranted. The present study profiled the national musculoskeletal APP services, focusing on service, clinician and patient outcome factors. METHODS: An online survey of physiotherapists in the allocated APP posts (n = 25) explored: service organization; clinician profile and experience of the advanced role; and patient wait times and outcome measures. Descriptive statistics were used to analyse hospital- and clinician-specific data, and a content analysis was performed to explore APP experiences. RESULTS: A 68% (n = 17) response from 13 sites was achieved, whereby 20 whole-time APP posts existed in services led by 91 consultant doctors. Co-location of APP and consultant clinics at 11 sites facilitated joint medical-APP processes, with between-site differences in autonomy to screen referral letters, and arrange investigations, injections and surgery. Although 83% had postgraduate qualifications, APPs also availed themselves of informal role-specific training. Positive APP experiences related to learning opportunities and clinical support networks but experiences were consultant dependent, with further service developments and formal training required to manage workloads. APPs reported reduced wait times and most commonly chose to capture function/disability in future evaluations. CONCLUSIONS: Variances existed in the organizational design and operating of APP services. Although highly experienced and qualified, APPs welcomed additional formal training and support, due to the complex, more medical nature of APP roles. Further formal evaluation, capturing patient outcomes, is proposed.
BACKGROUND: Since 2011, advanced practice physiotherapists (APPs) have triaged the care of patients awaiting orthopaedic and rheumatology consultant/specialist doctor appointments in Ireland. APP services have evolved across the major hospitals (n = 16) and, after 5 years, profiling and evaluation of APP services was warranted. The present study profiled the national musculoskeletal APP services, focusing on service, clinician and patient outcome factors. METHODS: An online survey of physiotherapists in the allocated APP posts (n = 25) explored: service organization; clinician profile and experience of the advanced role; and patient wait times and outcome measures. Descriptive statistics were used to analyse hospital- and clinician-specific data, and a content analysis was performed to explore APP experiences. RESULTS: A 68% (n = 17) response from 13 sites was achieved, whereby 20 whole-time APP posts existed in services led by 91 consultant doctors. Co-location of APP and consultant clinics at 11 sites facilitated joint medical-APP processes, with between-site differences in autonomy to screen referral letters, and arrange investigations, injections and surgery. Although 83% had postgraduate qualifications, APPs also availed themselves of informal role-specific training. Positive APP experiences related to learning opportunities and clinical support networks but experiences were consultant dependent, with further service developments and formal training required to manage workloads. APPs reported reduced wait times and most commonly chose to capture function/disability in future evaluations. CONCLUSIONS: Variances existed in the organizational design and operating of APP services. Although highly experienced and qualified, APPs welcomed additional formal training and support, due to the complex, more medical nature of APP roles. Further formal evaluation, capturing patient outcomes, is proposed.
Authors: Robyn Speerin; Christopher Needs; Jason Chua; Linda J Woodhouse; Margareta Nordin; Rhona McGlasson; Andrew M Briggs Journal: Best Pract Res Clin Rheumatol Date: 2020-07-25 Impact factor: 4.098
Authors: Cornelia Anne Barth; Maggie Donovan-Hall; Catherine Blake; Noor Jahan Akhtar; Joseph Martial Capo-Chichi; Cliona O'Sullivan Journal: Int J Environ Res Public Health Date: 2021-11-16 Impact factor: 3.390