Emergency Physiotherapy Practitioner

Overview

Initiative type

Model of Care

Status

Published

26 July 2017

Topic

Allied health Emergency Model of care Patient flow Physiotherapy

Summary

Using physiotherapists in the Emergency Department (ED) is beneficial when high numbers of musculoskeletal ED attendances are leading to long wait times. Key Principles are to assess patients with musculoskeletal injuries and take full responsibility for their care and patients seen in a primary care role and not required to see a medical practitioner

Key dates

Nov 2015 - Jul 2017

Implementation sites

Queensland Health Emergency Departments with high numbers of musculoskeletal presentations.

Partnerships

Collaboration between Gold Coast Hospital and Health Service, QEII, TPCH, RBWH, Princess Alexandra Hospital and Cairns Hospital has helped facilitate standardisation of the Emergency physiotherapy practitioner (EPP) role.

Aim

The aim is to manage these patients in a primary contact capacity, rather than all patients being seen by a doctor in the first instance. Musculoskeletal patients are seen by a physiotherapist first, and only referred to a doctor when necessary.

Benefits

reduced wait time
reduced occupancy time
improved patient care of musculoskeletal injuries
improved use of skill base (allow more time for doctors to manage time critical patients)

Background

An ageing population with increased chronicity of disease coupled with increased expectations of health consumers have led to increased demands on emergency departments. Experienced musculoskeletal physiotherapists working in emergency departments can be the first point of contact for patients with simple, semi-urgent and non-urgent peripheral musculoskeletal injuries, resulting in decreased waiting times and length of stay for patients without any adverse effects.

Solutions implemented

Models of care vary across the state. Some health services employ physiotherapists in an early assessment medical unit or MAPU, which may be located near the ED.

Evaluation and results

Formal evaluation not completed.

Lessons learnt

Development of formal role descriptions, competency and training guidelines, and governance and evaluation frameworks support statewide implementation of an Exposure Prone Procedure (EPP) model.

References

Bethel, J. (2005). The role of the physiotherapist practitioner in emergency departments: a critical appraisal. Emergency Nurse, 13:26-31.

Anaf S & Shepherd L. (2007). Describing physiotherapy interventions in emergency department setting: an observational pilot study. Accident and Emergency Nursing, 15(1):34-39.

Taylor NF et al (2011) Primary contact physiotherapy in emergency departments can reduce length of stay for patients with peripheral musculoskeletal injuries compared with secondary contact physiotherapy: a prospective non-randomised controlled trial. Physiotherapy, Jun 97(2):107-14.

Bird S et al (2016) Primary contact physiotherapy services reduce waiting times for patients presenting with musculoskeletal conditions in Australian emergency departments: an observational study.

Journal of Physiotherapy, 62(2016):209-214.

Key contact

Laureen Hines

Director

Healthcare Improvement Unit

Email: Laureen.Hines@health.qld.gov.au

Last updated: April 2025