A telephone assessment and advice service within an ED physiotherapy clinic: a single-site quality improvement cohort study

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Date
2021
Authors
Kelly, Marie
Higgins, Anna
Murphy, Adrian
McCreesh, Karen
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AboutScience Srl
Published Version
https://doi.org/10.1186/s40945-020-00098-4
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Abstract
Background: In response to issues with timely access and high non-attendance rates for Emergency Department(ED) physiotherapy, a telephone assessment and advice service was evaluated as part of a quality improvementproject. This telehealth option requires minimal resources, with the added benefit of allowing the healthcareprofessional streamline care. A primary aim was to investigate whether this service model can reduce wait timesand non-attendance rates, compared to usual care. A secondary aim was to evaluate service user acceptability.Methods: This was a single-site quality improvement cohort study that compares data on wait time to firstphysiotherapy contact, non-attendance rates and participant satisfaction between patients that opted for a servicebased on initial telephone assessment and advice, versus routine face-to-face appointments. 116 patients werereferred for ED physiotherapy over the 3-month pilot at the ED and out-patient physiotherapy department, XMercyUniversity Hospital, Cork, Ireland. 91 patients (78%) opted for the telephone assessment and advice service, with40% (n=36) contacting the service. 25 patients (22%) opted for the face-to-face service. Data on wait time and non-attendance rates was gathered using the hospital data reporting system. Satisfaction data was collected ondischarge using a satisfaction survey adapted from the General Practice Assessment Questionnaire. Independent-samples t-test or Mann Whitney U Test was utilised depending on the distribution of the data. For categorical data,Chi-Square tests were performed. A level of significance ofp≤0.05 was set for this study.Results: Those that contacted the telephone assessment and advice service had a significantly reduced wait time(median 6 days; 3–8 days) compared to those that opted for usual care (median 35 days; 19–39 days) (p≤0.05).There was no significant between-group differences for non-attendance rates or satisfaction.Conclusion: A telephone assessment and advice service may be useful in minimising delays for advice for thosereferred to ED Physiotherapy for musculoskeleltal problems. This telehealth option appears to be broadlyacceptable and since it can be introduced rapidly, it may be helpful in triaging referrals and minimising face-to-faceconsultations, in line with COVID-19 recommendations. However, a large scale randomised controlled trial iswarranted to confirm these findings.
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Keywords
Musculoskeletal , Non-attendance , Telephone triage , Timely access , Satisfaction
Citation
Kelly, M., Higgins, A., Murphy, A. and McCreesh, K. (2021) 'A telephone assessment and advice service within an ED physiotherapy clinic: a single-site quality improvement cohort study', Archives of Physiotherapy, 11(1), pp.1-9. https://doi.org/10.1186/s40945-020-00098-4
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https://hdl.handle.net/10468/16592
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Physiotherapy - Journal Articles
Medicine - Journal Articles
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© 2021, the Authors. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License,which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you giveappropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate ifchanges were made. The images or other third party material in this article are included in the article's Creative Commonslicence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commonslicence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtainpermission directly from the copyright holder. To view a copy of this licence, visithttp://creativecommons.org/licenses/by/4.0/.The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to thedata made available in this article, unless otherwise stated in a credit line to the data.