Experiences of Boosting Inpatient Exercise After Hip Fracture Surgery Using an Alternative Workforce – A Qualitative Study
Benny Ka Fai Lau1,2, Alison Harmer2, Marie March2,3, Sarah Dennis2,41Physiotherapy Department Fairfield Hospital – SWSLHD, Prairiewood, NSW, Australia2Sydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia3Physiotherapy Department Blacktown & Mount Druitt Hospital – WSLHD, Blacktown, NSW, Australia4Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia
Abstract
Background: Thrice-daily physiotherapy immediately following surgical repair of hip fracture has been shown to be safe and to reduce total hospital length of stay. However, implementing this is challenging with respect to health service funding and staffing. A novel approach may be to utilize an alternative workforce (allied health staff and student physiotherapists) to deliver two of the three daily treatments. However, how patients and staff may view such an approach is unknown. Thus, the aim of this qualitative study was to explore the views of inpatients with surgical repair of a hip fracture, their carers, health care professionals, and physiotherapy students about the implementation and acceptability of thrice-daily physiotherapy, with two sessions delivered by the alternative workforce (BOOST).
Methods: Semi-structured interviews and focus groups with patients, carers, health professionals and physiotherapy students. All interviews were digitally recorded and transcribed verbatim. The transcripts were coded, and the data analysed via inductive thematic analysis.
Results: A total of 32 interviews were analysed. Five main themes were identified. These were: (1) individual perceptions of the intervention: inpatients/carer/staff/student, (2) implementation within the service and organisational context, (3) implementation strategies that were effective, (4) improvements to implementation strategies/barriers to implementation/unsuccessful strategies and (5) future directions of BOOST.
Conclusions: The qualitative data revealed that higher frequency physiotherapy was well-received by inpatients and that staff/students involved in providing care perceived it as an acceptable and valuable practice. Implementation of higher daily frequency of physiotherapy using an alternative workforce is safe, acceptable and valuable, and may feasibly be adopted for inpatients following hip fracture surgery.
Biography
I am an extremely enthusiastic and passionate physiotherapist who is continually utilising and developing my acquired skills and experience to not only improve patients’ outcomes and quality of life, but also hope to one day give back to this area of healthcare through providing education for aspiring physiotherapists. I have particular interests in research directed at improving the way we treat and care for our patients as physiotherapists. With my energetic and lively personality, human centric management skills and close attention to detail, I have a lot to offer in the world of physiotherapy.