Affiliations: [a] Cappagh National Orthopaedic Hospital, Finglas, Dublin, Ireland
| [b] School of Public Health, Physiotherapy & Population Science, University College Dublin, Belfield, Dublin, Ireland
Correspondence:
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Corresponding author: Niall O’Mahony, Senior Physiotherapist, Department of Physiotherapy, Cappagh National Orthopaedic Hospital, Finglas, Dublin 11, Ireland. Tel.: +353868369127; E-mail: niallomahony28@gmail.com.
Abstract: BACKGROUND: Advanced practice physiotherapist (APP) triage posts were set up as a waiting list initiative in orthopaedics and rheumatology in the public healthcare setting. PURPOSE: The purpose of this study was to perform an analysis of embedded physiotherapists’ opinions on a new national initiative, across multiple centres in the Irish public healthcare setting. METHODS: This was a multi-stage project, involving semi structured interviews and self-reported questionnaire. Data were analysed using inductive qualitative methodology, with descriptive statistics, chi squared tests and odds ratios for quantitative data. RESULTS: Seventy nine percent (n = 19/24) of respondents felt that they had a good relationship with their consultant(s); while 48% (n = 12/25) were satisfied with the triage setup. By comparison to services where APP clinics operated independently from routine orthopaedic clinics, APPs were 5.4 times more likely to be satisfied if their clinic was located within the consultant clinic ‘greater than 75% of the time’ (99% CI, 1.22–23.96), decreasing to 2.71 times if in consultant clinics ‘50–75% of the time’ (99% CI, 1.26–5.84). Respondents also expressed higher satisfaction if greater than 50% of their educational opportunities (formal and informal) were within the consultant-led team setting (OR 1.64, CI 95% 1.00–2.68). Themes emergent from qualitative analysis were importance of the relationship with consultant and team; lack of formal educational opportunity; and concerns regarding access for patients to further investigations (e.g. radiology), consultant review and physiotherapy treatment. CONCLUSIONS: Specific triage models, team interaction and educational opportunities vary, influencing therapist satisfaction. Recommendations are made regarding future service provision and policy.
Keywords: Physiotherapy, musculoskeletal, triage, extended scope of practice
