Up to $325,000 to implement and evaluate an expanded scope of practice physiotherapist in Emergency Departments.
The Physiotherapists in the Emergency Department program focuses on the introduction of physiotherapist extended scope of practice roles into Emergency Departments (EDs) to assist with the problems associated with:
- Overcrowding from an increasing number of presentations to EDs.
- Workforce issues associated with the recruitment and retention of Fellows of the Australian College of Emergency Medicine (FACEMs) into EDs within Australia. There is a lack of publicly available recent workforce data for FACEMS. HWA is currently developing a National Training Plan for doctors, nurses and midwives that will provide further information on FACEMS in the future including projections of likely trends in health workforce supply and demand.
At present a third of patients are waiting longer than is clinically recommended in Emergency Departments. As part of national reform a Four Hour National Access Target has been set and workforce reforms are required to facilitate the delivery of this target .
Traditionally EDs have been staffed by doctors and nurses. Allied Health professionals such as Physiotherapists, Occupational Therapists, Social Workers, Radiographers and Pharmacists have been called to the ED on an ad hoc basis. However, there has been growing evidence for adopting a more multi-disciplinary approach to the management of patients in the ED . The benefits of employing allied health staff as established members of the ED service have been described in a growing body of literature and include:
- decreased length of stay in ED;
- decreased admission rates to in patient wards ; and
- decreased admission rates to ED .
There is also recent Australian evidence for reduction in wait and length of stay in EDs when physiotherapists provide frontline assessment and interventions of more simple musculo-skeletal injuries (Australasian Triage Scale level 4 and 5) bypassing management by the ED’s medical practitioners.
Advancing and extending the scope of Allied Health roles over and above the multidisciplinary team approach has the potential to assist in improving the quality of healthcare and mitigate the issues of medical workforce shortages in the ED. While such drivers exist, so do evidence gaps on the effectiveness and sustainability of these initiatives . Whilst there is indicative evidence of the benefits of such extended scope of roles there is little evidence base in relation to the productivity gains of the roles.
Physiotherapy roles have been implemented in EDs to variable degrees, but not all with an extension of scope of practice role. A number of jurisdictions are currently working on extended scope of practice roles.
Issues that are emerging from work currently being undertaken across Australia are that there does not appear to be consistency across hospitals and jurisdictions regarding experience, training and education.
Key Objectives of the Project
To identify models of extended scope of practice for physiotherapists in EDs that demonstrate improved productivity by improving patient flow, decreasing waiting time for patients in the ED and meeting KPIs for triage times by category and for 4 hours waiting time.
To develop corresponding toolkits and implementation guidelines including consideration of training requirements and training program to support national implementation.
HWA will provide funding of up to a maximum of $325,000 (excluding GST) to each of four eligible organisations. This funding will be provided over a nineteen-month period and will be disbursed over three phases. The distribution of funding over this period will be negotiable with successful respondents.
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Closing date is 2pm, Australian Central Standard Time (ACST), Friday 11 May 2012