Patients and hospital staff perceive diverting patients from the emergency department to physiotherapy outpatients as safe and effective: a qualitative descriptive study.

Abstract

Background: It is estimated that 6% to 12% of Australian emergency department (ED) presentations are due to musculoskeletal (MSK) conditions. In response, primary contact physiotherapy roles have developed in many Australian EDs. A further innovation is a diversion pathway for people with MSK conditions to move from the ED to a primary contact physiotherapy outpatient clinic.

Objective: To explore the perceptions of people with MSK conditions and hospital staff on diverting patients from the emergency department (ED) to receive care from primary contact physiotherapists in the outpatient setting.

Methods: A qualitative descriptive study with thematic analysis.

Results: Fourteen patient and 18 staff participants with experience of the diversion pathway were interviewed. There were four main themes combining staff and patient participant perspectives. The three combined themes were: (i) appropriateness of physiotherapists diverting patients from ED; (ii) communication; and (iii) impact of diverting patients from the ED. The unique staff theme was "staff perceptions of the diversion pathway." All patients felt diversion from the ED to see a physiotherapist in the outpatient clinic was appropriate, even if this was not their initial expectation of receiving care in the ED. Staff also perceived the diversion process as safe and valued addition to the ED. Both patient and staff participants described positive communication experiences from the physiotherapists in the diversion pathway. Several staff participants suggested improvements to the diversion pathway.

Conclusion: Patient and staff participants perceived the diversion pathway as a safe, appropriate and effective addition to the public general hospital ED processes.