Short waits, happy patients and expert care, moving basic musculoskeletal care from the ED to a physiotherapist led diversion pathway
Objective: Patients with musculoskeletal conditions are highly prevalent in emergency departments (ED). This project explores the impact of the pilot phase of a ‘diversion pathway’, which directed patients with musculoskeletal conditions from the ED waiting room to an outpatient clinic led by Advanc...
| Main Authors: | , , , , , , , , , |
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| Format: | Journal Article |
| Published: |
Wiley-Blackwell
2024
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| Online Access: | http://hdl.handle.net/20.500.11937/94863 |
| _version_ | 1848765938227216384 |
|---|---|
| author | Truter, Piers Flanagan, Pippa Waller, Robert Richards, Karen Makate, Marshall Johnstone, Anthony Bongiascia, Luke Spilsbury, Katrina Cavalheri, Vinicius Lin, Ivan |
| author_facet | Truter, Piers Flanagan, Pippa Waller, Robert Richards, Karen Makate, Marshall Johnstone, Anthony Bongiascia, Luke Spilsbury, Katrina Cavalheri, Vinicius Lin, Ivan |
| author_sort | Truter, Piers |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Objective: Patients with musculoskeletal conditions are highly prevalent in emergency departments (ED). This project explores the impact of the pilot phase of a ‘diversion pathway’, which directed patients with musculoskeletal conditions from the ED waiting room to an outpatient clinic led by Advanced Scope Physiotherapists.
Methods: A prospective intervention study comparing care outcomes between patients in the ‘diversion pathway’ with usual ED care. The characteristics of patients considered eligible and non-eligible are
described.
Results: Between May and December 2022, 1,099 patients were diverted. For diverted patients, mean length of stay (LOS) in ED was reduced by 110 (95%, CI 99–120) minutes and 4-hour rule compliance improved 19.3% compared to usual ED care. There were fewer patients that ‘did not wait’ (DNW) with the diversion pathway. The diverted group
was young (median age 22 years and 41% paediatric), mostly low urgency, self-referred and arrived by private transport with minor limb trauma. The diversion pathway triage process appropriately identified 182 patients ineligible for diversion. 96.7% of patients reported satisfaction with care received from the diversion pathway. There was no
change in ED representation rates for diverted patients.
Conclusions:
A new pathway resulted in reduced LOS, reduced DNW, high patient satisfaction and more people being discharged within 4 hours for diverted patients compared to usual ED care. The pathway increased ED capacity, improved key ED performance metrics and safely expedited care delivery for patients. |
| first_indexed | 2025-11-14T11:43:12Z |
| format | Journal Article |
| id | curtin-20.500.11937-94863 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T11:43:12Z |
| publishDate | 2024 |
| publisher | Wiley-Blackwell |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-948632024-05-24T07:03:33Z Short waits, happy patients and expert care, moving basic musculoskeletal care from the ED to a physiotherapist led diversion pathway Truter, Piers Flanagan, Pippa Waller, Robert Richards, Karen Makate, Marshall Johnstone, Anthony Bongiascia, Luke Spilsbury, Katrina Cavalheri, Vinicius Lin, Ivan Objective: Patients with musculoskeletal conditions are highly prevalent in emergency departments (ED). This project explores the impact of the pilot phase of a ‘diversion pathway’, which directed patients with musculoskeletal conditions from the ED waiting room to an outpatient clinic led by Advanced Scope Physiotherapists. Methods: A prospective intervention study comparing care outcomes between patients in the ‘diversion pathway’ with usual ED care. The characteristics of patients considered eligible and non-eligible are described. Results: Between May and December 2022, 1,099 patients were diverted. For diverted patients, mean length of stay (LOS) in ED was reduced by 110 (95%, CI 99–120) minutes and 4-hour rule compliance improved 19.3% compared to usual ED care. There were fewer patients that ‘did not wait’ (DNW) with the diversion pathway. The diverted group was young (median age 22 years and 41% paediatric), mostly low urgency, self-referred and arrived by private transport with minor limb trauma. The diversion pathway triage process appropriately identified 182 patients ineligible for diversion. 96.7% of patients reported satisfaction with care received from the diversion pathway. There was no change in ED representation rates for diverted patients. Conclusions: A new pathway resulted in reduced LOS, reduced DNW, high patient satisfaction and more people being discharged within 4 hours for diverted patients compared to usual ED care. The pathway increased ED capacity, improved key ED performance metrics and safely expedited care delivery for patients. 2024 Journal Article http://hdl.handle.net/20.500.11937/94863 http://creativecommons.org/licenses/by-nc/4.0/ Wiley-Blackwell fulltext |
| spellingShingle | Truter, Piers Flanagan, Pippa Waller, Robert Richards, Karen Makate, Marshall Johnstone, Anthony Bongiascia, Luke Spilsbury, Katrina Cavalheri, Vinicius Lin, Ivan Short waits, happy patients and expert care, moving basic musculoskeletal care from the ED to a physiotherapist led diversion pathway |
| title | Short waits, happy patients and expert care, moving basic musculoskeletal care from the ED to a physiotherapist led diversion pathway |
| title_full | Short waits, happy patients and expert care, moving basic musculoskeletal care from the ED to a physiotherapist led diversion pathway |
| title_fullStr | Short waits, happy patients and expert care, moving basic musculoskeletal care from the ED to a physiotherapist led diversion pathway |
| title_full_unstemmed | Short waits, happy patients and expert care, moving basic musculoskeletal care from the ED to a physiotherapist led diversion pathway |
| title_short | Short waits, happy patients and expert care, moving basic musculoskeletal care from the ED to a physiotherapist led diversion pathway |
| title_sort | short waits, happy patients and expert care, moving basic musculoskeletal care from the ed to a physiotherapist led diversion pathway |
| url | http://hdl.handle.net/20.500.11937/94863 |