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 improvement project . This telehealth option requires minimal resources, with the added benefit of allowing the healthcare professional streamline care . A primary aim was to investigate whether this service model can reduce wait times and 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 first physiotherapy contact, non-attendance rates and participant satisfaction between patients that opted for a service based on initial telephone assessment and advice, versus routine face-to-face appointments . 116 patients were referred for ED physiotherapy over the 3-month pilot at the ED and out-patient physiotherapy department, XMercy University Hospital, Cork, Ireland . 91 patients (78 %) opted for the telephone assessment and advice service, with 40% (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 on discharge 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 of p ≤ 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 those referred to ED Physiotherapy for musculoskeleltal problems . This telehealth option appears to be broadly acceptable and since it can be introduced rapidly, it may be helpful in triaging referrals and minimising face-to-face consultations, in line with COVID-19 recommendations . However, a large scale randomised controlled trial is warranted to confirm these findings.
Index: Musculoskeletal, Non-attendance, Satisfaction, Telephone triage, Timely access