Advanced musculoskeletal physiotherapy practice in Ireland: A National Survey.
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Authors
Fennelly, OrnaBlake, Catherine
FitzGerald, Oliver
Breen, Roisin
O'Sullivan, Cliona
O'Mir, Marie
Desmeules, François
Cunningham, Caitriona
Issue Date
2018-01-01Keywords
extended scopeorthopaedics
physiotherapy
rheumatology
triage
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Musculoskeletal CareJournal
Musculoskeletal CareDOI
10.1002/msc.1351PubMed ID
29927063Abstract
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. 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. 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. 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.Item Type
ArticleLanguage
enISSN
1557-0681ae974a485f413a2113503eed53cd6c53
10.1002/msc.1351
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