Dr Piers Truter1,2,3,4,5, Ms Melissa Woodall4, Ms Julie Walker6, Ms Emma Davies1, Mr Lynton Norris7, Ms Pippa Flanagan4,5,8, A/Prof Vinicius Cavalheri8,9
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, 6Consumer Mentor, Perth, Australia, 7PFS Consulting,, Sydney, 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 provided data on effectiveness, justified ongoing funding and supports future expansion.
Issue under consideration:
In response to Emergency Department (ED) overcrowding, 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:
11,000 people were diverted since February 2022. The clinical team shared the findings via 3 papers and, with an external consultant, completed an economic analysis of the diversion pathway. These data profile diversion suitable ED patients, the value of diverting different patient populations and an annual return of over 7,400 hours of ED capacity. Modelling of the impact on i) the index ED (62,000 patients/year), ii) a tertiary ED (110,000 patients/year) and iii) a regional ED (45,000 patients/year) will be discussed, including potential workforce profiles.
Conclusion:
The ED diversion pathway is a sustainable allied health advanced practice solution to the provision of the right care in the right setting, at a lower cost. A strong research evaluation agenda facilitated support for funding and expansion.