Enhancing Acute Musculoskeletal Patient Care in Beaumont ED
Beaumont Hospital's Physiotherapy Department, led by Senior MSK Physiotherapist Enda McCarthy, has seized the opportunity during the pandemic to improve the acute musculoskeletal journey of patients in the Emergency Department. By implementing a service development strategy focusing on assessing and treating patients within the ED setting, the department aims to limit the risk of COVID-19 transmission, reduce wait times, increase patient volumes, and ensure timely care delivery. The initiative has resulted in significant improvements in patient care and outcomes, with a focus on sustainability and patient empowerment.
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Pandemic Seizing the opportunity to improve patients acute musculoskeletal journey in the Emergency Department. BEAUMONT HOSPITAL PHYSIOTHERAPY DEPARTMENT ENDA MCCARTHY SENIOR EMERGENCY DEPARTMENT MSK PHYSIOTHERAPIST
Emergency Department (ED) Musculoskeletal (MSK) BACKGROUND AIM To assess and treat appropriate patients within the Beaumont ED clinical setting as they present to the emergency department. Service provides assessment and management of acute MSK injuries for patients who attend ED in Beaumont Hospital. Objectives: Prior to the global pandemic, these patients were electronically referred and reviewed in the physiotherapy OPD after the patient opted in. 1. Limit the risk of hospital or community acquired covid 19 by reducing representation to physio OPD. 2. Limitations of telehealth and infrastructure In response to the pandemic in 2020, a service development strategy was implemented to assess and treat patients when they present to ED after they have been triaged by an ANP/NCHD/Consultant and MSK physio is deemed the appropriate pathway. 3. Patient pathway right person, right place, right time. 4. Improve patients wait time/ journey 5. Ensure all appropriate patients were seen by having a larger physical presence in ED.
Average number of days waiting for ED MSK physiotherapy 12.00 10.00 10.00 8.227.82 8.00 6.57 6.46 25% increase in patients referred annually 6.00 4.40 4.00 2.56 1.91 2.00 75% reduction in wait time since this service strategy commenced. 0.00 2014 2015 2016 2017 2018 2019 2020 2021 2021 32% of patients were discharged after one session Days Average number of reviews per ED patient 2021 Assessment, treatment and education at the earliest possible stage can significantly reduce the ongoing demand on ED physiotherapy 7%12% 1 2 32% 10% 3 4 17% 22%
SUSTAINMENT VALUE TO THE PATIENTS Advanced Practice Physiotherapy (APP) business case has been developed and is awaiting submission. Patients are reviewed at initial presentation. Patients are placed on appropriate treatment pathway at the earliest possible stage and recover quicker. CHALLENGES Caseload Management 2 different clinical areas Patients have a greater understanding of their condition. Acute MSK conditions often same day injury and assessment Developed & maintained a significant improvement in waiting time. Self management strategies Reduce re-presenation
