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Deborah Lenaghan Advanced Scope Physiotherapist Dr Paul Bowe Director ED Robina Extended Scope of Physiotherapy Emergency Department Health Workforce Australia.

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Presentation on theme: "Deborah Lenaghan Advanced Scope Physiotherapist Dr Paul Bowe Director ED Robina Extended Scope of Physiotherapy Emergency Department Health Workforce Australia."— Presentation transcript:

1 Deborah Lenaghan Advanced Scope Physiotherapist Dr Paul Bowe Director ED Robina Extended Scope of Physiotherapy Emergency Department Health Workforce Australia (HWA) Funded Project

2 SERVICE DETAILS  Robina Hospital is an acute bed (360) hospital and is part of the Gold Coast Hospital and Health Service  GCHHS had 125,745 ED presentations 12/13financial year,  Southport 69,076 ( NEAT 64%)  Robina 56,667 (NEAT 79%)

3 NEAT Targets to be phased in 2015 Jurisdiction Baseline NSW61.8%69%76%83%90% VIC65.9%72%78%84%90% QLD63.8%70%77%83%90% WA71.3%76%81%85%90% SA59.4%67%75%82%90% TAS66.0%72%78%84%90% ACT55.8%64%73%81%90% NT66.2%72%78%84%90%

4 ENABLERS  The Districts focus on NEAT performance  Austerity measures.  State wide Ministerial Taskforce on Expanded Scope of Practice underway.  Networks

5 Performance against NEAT- Robina District focus on Neat

6 PCP ROLE  TURN AROUND TIME 90 mins  EARLY ASSESSMENT and INVESTIGATION AFTER TRIAGE  TREATMENT  PT EDUCATION and EXPECTATIONS regarding RECOVERY

7 S Ankle- Sprain / Strain S Fractured Radius T00.260Contusions Lower Limb S62.058Fractured Scaphoid T00.356Contusions Upper Limb S92.254Fractured Lower Limb S Wrist -Sprain /Strain S82.448Fractured Fibula S62.639Fractured Finger M24.238Knee ligament or tendon injury Others711 TOTAL1362 Top 10 Oct12- Sep 2013

8 Percentages of through put

9 Patient Compliments Completely professional, extremely efficient. I was absolutely taken a back, by how quickly things were moving. Having been to the Emergency Dept on a number of occasions and having to sit through very long waits, I found this new system to be a breath of fresh air. I felt it important to pass on my positive feedback, I would also like to emphasise the care that we received was faultless. polite, friendly, efficient and very professional. I would like to congratulate the Hospital for looking at ways to improve their services. This program can only be a good thing and I hope it will continue indefinitely.

10 COMPLIMENTS

11 STAFF SURVEY  PRELIMINARY RESULTS ONLY  Provided by Cristina J Thompson University of Wollongong Terminology:  Primary Contact Physiotherapist PCP

12 STAFF SURVEY 52 RESPONDENTS

13 52 RESPONDENTS

14 LEVEL OF AGREEMENT

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21 THEMES from STAFF improved patient flow within the Fast Track zone of the ED and contributed to improvements in NEAT performance improved patient care for patients presenting with a musculo-skeletal injury contributed to the education and mentoring of other ED personnel through their advanced knowledge and expertise in managing musculo- skeletal presentations complemented the skill mix of the ED

22 STAFF COMMENTS “The primary contact physiotherapist role in ED is beneficial for patients and staff alike. There is a definite improvement in flow through fast track. The physio has an excellent knowledge base and is certainly an asset to the department.” – Nursing staff “It is hugely helpful having an ED primary contact physiotherapist in the department. They are extremely valuable members of the team and their knowledge and expertise are vital in the ED setting. They provide excellent care to the relevant patients and make a positive difference to the work load.” – Medical staff

23 STAFF COMMENTS “The ED primary contact physiotherapist complements well the skill mix of the ED team to care for patients with musculoskeletal problems and has worked extremely well in our ED.” – Medical Staff

24 STAFF COMMENTS “… The physiotherapists increased knowledge of fractures and mechanisms of injury has improved the patients’ process through the ED department, with more relevant requests and many diagnoses have been made that might have been missed without her input.” – Allied Health Staff

25 SOME CONCERNS the usefulness of the role may be dependent on the person in the role there appears to be reluctance by some inpatient medical officers to accept referrals from the PCP the outcomes of the PCP should be understood in relation the specific patient cohort managed and that this may not be representative of outcomes for other patients managed in the Fast Track zone of the ED the patient cohort seen by the PCP should be appropriate to the role, for example, Triage Category 2 patients may not be appropriate.

26 Re-presentation rates

27 Robina DNW %

28 Embedding the Role  Recognised and reported on at an Executive Level.  Supported verbally at a local level by the Directors of ED.  Continued positive feedback from ED staff and Patients.  Local and National Evaluation being undertaken.

29 FUTURE SUSTAINABILITY  Uncertainty - HH& S restructuring to service line management model  Funding

30 Influential Relationship Development  Time  Respect  Flexibility

31 CONCLUDING THOUGHTS  PCP selection  Challenging traditional medical roles  ED design (waiting rooms & treatment areas)  Emphasis of patient flow and journey  Training ED team in MSK conditions

32 Deborah Lenaghan Advanced Scope Physiotherapist Dr Paul Bowe Director ED Robina Extended Scope of Physiotherapy Emergency Department Health Workforce Australia (HWA) Funded Project

33 Percentage seen in clinically recommended time


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