Early Allied Health Intervention in the Emergency and Trauma Centre Improves Outcomes for General Medicine Admissions: A Pilot Study
David Briggs1, Amy Wilson1, Valentina Maric2, Lara Kimmel1,31Physiotherapy Department, Alfred Health, Melbourne, Victoria, Australia2Allied Health Executive, Alfred Health, Melbourne, Victoria, Australia3Monash University, Melbourne, Victoria, Australia
Abstract
Background: General medical patients who are admitted via the Emergency and Trauma Centre (E&TC) are not routinely evaluated by the E&TC Allied Health (AH) team. This pilot study aimed to assess the benefits of providing early AH input to these patients.
Methods: An additional AH resource was available 8:00 am – 4:30 pm, 5 days a week between October and December 2022 to see E&TC patients referred by the General Medicine streaming registrar. Demographic data was collected as was length of stay (LOS), time to assessment, disposition, and readmission. Two control groups were included; one pre-intervention and one during the pilot.
Results: During the two-month pilot, 51 patients were seen by AH in the E&TC. Pilot patients were significantly older (median age 85; 80/78 in control groups), and had a shorter time to review by AH (median 13 hours; 39 hours in both control groups). The pilot group had more patients discharged home (12% vs 8% and 9%), and a higher percentage were transferred to other institutions, rather than being admitted. There was a trend towards patients having a shorter LOS and no differences in readmission rates. The AH service was also well received by staff.
Discussion: The findings suggest that early AH input may facilitate earlier discharge and reduce unnecessary ward transfers. The older age of patients in the pilot group may have influenced the streaming locations. Further studies with larger sample sizes may show significant differences in LOS to further promote this initiative.
Biography
David has worked at Alfred Health for over 15 years primarily in the advanced practice musculoskeletal field with a particular interest in primary contact physiotherapy in the emergency department. More recently he has grown his interest in service delivery and alternative models of care.