Orna Fennelly1, Catherine Blake2, Oliver FitzGerald3, Aoife Caffrey4, Laura Fletcher5, Keith Smart6, Siobhan Corcoran7, Éidín Ní Shé8, Sarah Casserley-Feeney9, François Desmeules10, Caitriona Cunningham11. 1. School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin, Ireland. Electronic address: orna.fennelly@ucdconnect.ie. 2. School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin, Ireland. Electronic address: c.blake@ucd.ie. 3. Department of Rheumatology, St. Vincent's University Hospital, Dublin, Ireland; Conway Institute, University College Dublin, Belfield, Dublin, Ireland. Electronic address: oliver.fitzgerald@ucd.ie. 4. Bone and Joint Clinic, St. Vincent's University Hospital, Dublin, Ireland. Electronic address: acaffrey@svhg.ie. 5. Physiotherapy Department, University Hospital Waterford, Waterford, Ireland. Electronic address: LauraF.Fletcher@hse.ie. 6. Bone and Joint Clinic, St. Vincent's University Hospital, Dublin, Ireland. Electronic address: KSmart@svhg.ie. 7. Physiotherapy Department, University Hospital Waterford, Waterford, Ireland. Electronic address: siobhanm.corcoran@hse.ie. 8. School of Nursing and Health Systems, University College Dublin, Belfield, Dublin, Ireland. Electronic address: eidin.nishe@ucd.ie. 9. Physiotherapy Department, Sligo University Hospital, Sligo, Ireland. Electronic address: Sarah.Casserley@hse.ie. 10. School of Rehabilitation, University of Montreal, Canada. Electronic address: f.desmeules@umontreal.ca. 11. School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin, Ireland. Electronic address: caitriona.g.cunningham@ucd.ie.
Abstract
BACKGROUND: As many patients referred to orthopaedic and rheumatology services do not require medical or surgical interventions, advanced practice physiotherapists (APPs) have been introduced into hospital services to triage the care of these patients. Patient perspectives are critical to review the acceptance of this model of care and potential for expansion into primary care. This study aimed to explore the clinical journeys, and the experiences and perceptions of patients attending APP services. METHOD: Semi-structured interviews (n = 10) were conducted with patients across two hospital sites, with narrative data subjected to a thematic analysis. MSK journeys were mapped via medical chart and interview data, with surveys collecting demographics. RESULTS: Patient journeys involved multiple contact points and some duplication in MSK health services. Overall, experiences of the APP service were positive, with faster access into the hospital system and patients valued the interpersonal and professional skills of the APP. Having already attended a physiotherapist, some patients did have a preconception of what the APP could offer them. However, initial concerns were mitigated following the APP appointment, as the APP had extensive MSK knowledge. Hospitals remained the preferred location for MSK appointments due to availability of diagnostics and 'specialists', and close proximity of the doctor. CONCLUSION: Patients were positive about the new MSK APP service and benefits related to shorter wait times and seeing a specialist who listened and involved them in their management. However, a cultural shift regarding patient perceptions of the 'specialists' in hospitals and the role of a physiotherapist is required.
BACKGROUND: As many patients referred to orthopaedic and rheumatology services do not require medical or surgical interventions, advanced practice physiotherapists (APPs) have been introduced into hospital services to triage the care of these patients. Patient perspectives are critical to review the acceptance of this model of care and potential for expansion into primary care. This study aimed to explore the clinical journeys, and the experiences and perceptions of patients attending APP services. METHOD: Semi-structured interviews (n = 10) were conducted with patients across two hospital sites, with narrative data subjected to a thematic analysis. MSK journeys were mapped via medical chart and interview data, with surveys collecting demographics. RESULTS:Patient journeys involved multiple contact points and some duplication in MSK health services. Overall, experiences of the APP service were positive, with faster access into the hospital system and patients valued the interpersonal and professional skills of the APP. Having already attended a physiotherapist, some patients did have a preconception of what the APP could offer them. However, initial concerns were mitigated following the APP appointment, as the APP had extensive MSK knowledge. Hospitals remained the preferred location for MSK appointments due to availability of diagnostics and 'specialists', and close proximity of the doctor. CONCLUSION:Patients were positive about the new MSK APP service and benefits related to shorter wait times and seeing a specialist who listened and involved them in their management. However, a cultural shift regarding patient perceptions of the 'specialists' in hospitals and the role of a physiotherapist is required.
Authors: Andre Leme Fleury; Sara Miriam Goldchmit; Maria Alice Gonzales; Rafaella Rogatto de Farias; Tiago Lazzaretti Fernandes Journal: Curr Rev Musculoskelet Med Date: 2022-03-14