Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association

Just Accepted

This article has been peer reviewed and accepted for publication. It is in production and has not been edited, so may differ from the final published form.

Management of patients brought in by ambulance to the Emergency Department: the role of the Advanced Musculoskeletal Physiotherapist.

Rita Kinsella , Tom Collins , Bridget Shaw , James Sayer , Belinda Cary , Andrew Walby , Sallie Cowan

Abstract

Objective: To evaluate the Advanced Musculoskeletal Physiotherapists' (AMP) role in managing patients brought in by ambulance to the Emergency Department (ED). Methods: A dual-centered observational study. Patients brought in by ambulance to two Melbourne hospitals over a 12 month period and seen by the AMP, were compared with a matched group seen by other ED staff. Primary outcome measures: wait time and length of stay. Results: Data from 1441 patients within the Australasian Triage Scale (ATS) Categories 3-5, with musculoskeletal complaints were included in the analysis. Sub-group analysis of 825 patients aged 65 and under demonstrated that for Category 4 (semi-urgent), median wait time to see the AMP was 9.5 minutes (interquartile range 13 minutes) compared to 25 minutes (interquartile range 20 minutes) for other ED staff (p= 0.00). Length of stay analysis was undertaken on patients discharged home demonstrating there was a 1.20 greater probability (95% confidence interval 1.07-1.35) that ATS Category 4 patients managed by the AMP were discharged within the 4 hour public hospital target compared to patients managed by other ED staff: 87.04% (94/108) of patients managed by the AMPs met this standard compared with 72.35% (123/170) of patients managed by other ED staff (p=0.002). Conclusions: Patients aged 65 and under, with musculoskeletal complaints, brought in by ambulance to emergency and triaged to ATS Category 4 are likely to wait less time to be seen and are discharged home more quickly when managed by the AMP. This study has added to the evidence that AMPs improve patient flow in emergency, freeing up time for other ED staff to see higher acuity more complex patients.

AH16094  Accepted 09 March 2017

© CSIRO 2017