Date of prep: December 2020
Prescribing information and
adverse events reporting
For healthcare professionals only
A programme that placed a physiotherapist into the emergency department of Glasgow’s Queen Elizabeth Hospital has now trebled in size after a successful trial.
Over 90% of patients seen by the physiotherapist were discharged from the emergency department following treatment. The average time to first assessment was just 56 minutes, with the time in physiotherapy treatment taking 43 minutes.
The trial found more than one in ten people were attending A&E due to musculoskeletal conditions, such as back pain and joint injuries.The Queen Elizabeth University Hospital now has three physiotherapists to provide cover seven days a week in its emergency department after the four-month pilot featuring one physio.
Physiotherapist Karen Aiken said: “This is a really forward-thinking way of working.
“Data gathered throughout the trial showed that musculoskeletal (MSK) conditions account for around 13% of the people who attend emergency departments (ED), which isn’t the most appropriate place for them. The trial showed the physio could meet 5% of the MSK demand.
“Physios have more time to work with patients in ED so we are ideally placed to see people who are not medical emergencies. This, in turn, frees up consultants to deal with medical priorities such as heart attacks.
“It also gives us the opportunity to see people when an injury is fresh meaning we can not only stop it from getting worse but also work out a plan of rehabilitation that saves them having to attend a series of physio appointments while also filtering away from GPs.
“Importantly, patient satisfaction has been positive with this approach with a number of people saying that seeing me was really helpful.
“It also supports the four hour ED target of assessing, triaging and admitting or discharging patients.”
Claire Ritchie, allied healthcare professional director with NHS Greater Glasgow & Clyde, said: “When we planned this way of working we had a real focus on using the physio’s professional expertise to best manage the flow of MSK presentations we were seeing in ED.
“While it isn’t the best place for these patients having a physio in the ED meant they were seen by the right professional and received a quality of care which, in many cases, meant there was no need for a period of ongoing physio.
“Our physios are now integrated within the ED team and, importantly, are there to meet patient demand when it is greatest. They work flexible shifts and weekends to ensure, that as a team, they always have a presence in the department.
“Feedback from both the physiotherapy staff and the ED teams they worked with showed the flexible shift pattern and the weekend cover was positive and important in supporting the flow of ED patients.
“We’re now seeing that extending their clinical skills would be beneficial to their role and increase the number of patients they could potentially see and further integrate the team within the unit.
“These additional skills have the potential to include wound closure, dressings, injection therapy for inflammatory conditions and would potentially mean a further 400 additional patients could be seen by one of the physios each week.
“There is also scope to train them in non-medical prescribing so that they can administer appropriate medications such as painkillers, antibiotics and anti-inflammatories to patients.
“Likewise, the fact that they are already experts in MSK assessment and management means they are an invaluable resource for teaching and training junior doctors, nursing staff and emergency nurse practitioners.”
Pharmacy in Practice is a UK pharmacy publication with its roots in Scotland.