Dr Piers Truter1,2,3,4,5, Ms Jane Gaspar6, Ms Melissa Woodall4, Ms Julie Walker7, Ms Emma Davies1, A/Prof Vinicius Cavalheri8,9, Prof Caroline Bulsara6
1Kaartdijin Innovation Centre, South Metropolitan Health Service, Murdoch, Australia, 2WA Health Chief Allied Health Office, East Perth, Australia, 3School of Health Sciences, University of Notre Dame Australia, Fremantle , Australia, 4Physiotherapy Department, Rockingham General Hospital, Cooloongup, Australia, 5Physiotherapy Department, Fiona Stanley Hospital, Murdoch, Australia, 6Institute for Health Research, University of Notre Dame, Australia, Fremantle, Australia, 7Consumer Mentor, Perth, Australia, 8Curtin School of Allied Health, Curtin University, Bentley, Australia, 9Allied Health Research Unit, South Metropolitan Health Service, Murdoch, Australia
Biography:
Piers Truter is a clinician, health system innovator and researcher focused on improving public hospital care for people with musculoskeletal injuries. He has led the development of a virtual fracture clinic and an emergency department diversion pathway within the South Metropolitan Health Service in Perth, Western Australia.
Piers brings clinical expertise as an advanced scope physiotherapist in the Emergency and Orthopaedic Departments. His PhD and WA Health FHRI Research and Innovation Fellowship focused on telehealth, emergency management of injury and patient-centred health system redesign. Piers works with the WA CAHO to foster the development of allied health advanced practice.
Abstract:
Purpose:
To explore how a research agenda linked to a novel allied health advanced practice model of care engaged with local consumers, patients and hospital staff members to put patient experience at the heart of health service change
Issue under consideration:
In response to Emergency Department (ED) crowding, an advanced scope physiotherapy (ASP) ED diversion pathway was implemented at a secondary hospital in Perth, Australia in 2022. In summary, patients presenting to ED with musculoskeletal conditions (pains, sprains and fractures) suitable for treatment by a physiotherapist, are screened in the ED waiting room by an ASP for suitability and transferred to an urgent care outpatient clinic. In 2023, a WA Health Research and Innovation Fellowship was awarded to one ASP (PT), which facilitated a research evaluation of the diversion pathway.
Nature and scope of Topic:
The clinical team produced qualitative research (32 interviews) and a consumer co-designed World Cafe with 10 consumers, in June, 2024. Patients and hospital staff agreed that diverting patients from the ED was safe and effective. Staff described implementation issues and recommended service improvements. Consumers identified access barriers in primary care (e.g. cost, GP access, continuity of care, suitability of GP care) that led to ED presentation. Consumers endorsed the diversion pathway concept and outlined ideas for future research and health service innovation.
Conclusion:
The Diversion pathway is a sustainable allied health advanced practice solution to health service and patient issues. A linked consumer, patient and staff experience research agenda provides direction for health service innovation.