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physioscience 2022; 18(02): 69-76
DOI: 10.1055/a-1500-1077
Original Paper

Musculoskeletal Physiotherapy in the Emergency Department – Evaluation of a New Physiotherapy Service in a Swiss University Hospital

Muskuloskelettale Physiotherapie in der Notaufnahme – Evaluation eines neuen physiotherapeutischen Dienstes in einem Schweizer Universitätsspital
Balz Winteler
1   Bern University of Applied Sciences, Academic Practice Partnership (APP) with Insel Gruppe, Bern, Switzerland
2   Bern University Hospital, Inselspital, Department of Physiotherapy, Insel Gruppe, Bern, Switzerland
,
Franziska Geese
1   Bern University of Applied Sciences, Academic Practice Partnership (APP) with Insel Gruppe, Bern, Switzerland
,
Beat Lehmann
3   Bern University Hospital, University of Bern, Department of Emergency Medicine, Inselspital, Bern, Switzerland
,
Kai-Uwe Schmitt
1   Bern University of Applied Sciences, Academic Practice Partnership (APP) with Insel Gruppe, Bern, Switzerland
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Abstract

Background Many countries report a significant increase in emergency department (ED) visits. Patients with musculoskeletal disorders account for a large proportion of non-urgent cases.

Objective Characterization and evaluation of a new service that provides immediate access to physiotherapy for patients in the ED.

Method To characterize a new service at the Department of Emergency Medicine, Bern University Hospital, and to evaluate first experiences with it, a mixed methods approach was chosen. Data was collected from the electronic patient file and from a logbook kept by the physiotherapists. In addition, guideline-based interviews with involved health care staff were conducted.

Results During the 63 days of the pilot study 79 patients were treated by physiotherapists. The most frequently reported patient complaint was back pain (47 %). Interventions included taking the medical history, performing manual tests and multimodal treatment and developing recommendations for further treatment. In 59 % of patients no medical imaging and in 58 % no additional physiotherapy was prescribed. Patients rated the physiotherapeutic service as very good or excellent (88 %). Physiotherapy was experienced as positive and appreciated by the other professions, and all interviewees emphasized the added value for patients.

Conclusion The pilot study indicates that the physiotherapeutic consultation service has the potential to improve quality of care. The findings of this study are therefore valuable when considering the introduction of such a service in an ED.

Zusammenfassung

Hintergrund Viele Länder berichten über einen signifikanten Anstieg von Behandlungen in der Notaufnahme. Patient*innen mit muskuloskelettalen Erkrankungen machen einen großen Anteil der nicht dringenden Fälle aus.

Ziel Charakterisierung und Evaluation eines neuen Dienstes, der Patient*innen in der Notaufnahme einen sofortigen Zugang zur Physiotherapie bietet.

Methode Um den neuen Dienst im Notfallzentrum des Universitätsspitals Bern zu charakterisieren und erste Erfahrungen zu evaluieren, wurde ein gemischter methodischer Ansatz gewählt. Dabei wurden Daten aus der elektronischen Patientenakte und aus einem von Physiotherapeut*innen geführten Logbuch gesammelt. Zusätzlich wurden Leitfaden gestützte Interviews mit involvierten Gesundheitsfachpersonen durchgeführt.

Ergebnisse Während der 63 Tage der Pilotstudie wurden 79 Patient*innen von Physiotherapeut*innen behandelt. Rückenschmerzen waren die häufigsten Beschwerden (47 %). Die Interventionen umfassten die Erebung der Anamnese, die Durchführung manueller Tests und multimodaler Behandlungen sowie die Entwicklung von Empfehlungen für die weitere Behandlung. Bei 59 % der Patient*innen wurde keine medizinische Bildgebung und bei 58 % keine zusätzliche Physiotherapie verordnet. Die Patient*innen bewerteten die physiotherapeutische Leistung als sehr gut oder ausgezeichnet (88 %). Die Physiotherapie wurde von den anderen Berufsgruppen als positiv erlebt und geschätzt, und alle interviewten Personen betonten den Mehrwert für die Patient*innen.

Schlussfolgerung Die Pilotstudie liefert Hinweise darauf, dass der physiotherapeutische Konsiliardienst das Potential hat, die Qualität der Versorgung zu verbessern. Die Erkenntnisse dieser Studie sind daher bei Überlegungen zur Einführung eines solchen Dienstes in einer Notaufnahme wertvoll.

Key words

musculoskeletal diseases - emergency service - hospital - specialty physical therapy

Schlüsselwörter

Muskuloskelettale Erkrankungen - Notdienst - Krankenhaus - Fachgebiet Physiotherapie


Publication History

Received: 04 May 2021

Accepted: 04 October 2021

Article published online:
16 November 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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