Enhancing Acute Musculoskeletal Patient Care in Beaumont ED

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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
 
 
S
ervice provides assessment and management of
acute MSK injuries for patients who attend ED in
Beaumont Hospital.
 
Prior to the global pandemic, these patients were
electronically referred and reviewed in the
physiotherapy OPD after the patient opted in.
 
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.
 
AIM
 
 
T
o assess and treat appropriate patients within the
Beaumont ED clinical setting as they present to the
emergency department.
Objectives:
1.
Limit the risk of hospital or community acquired
covid 19 by reducing representation to physio OPD.
2.
Limitations of telehealth and infrastructure
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.
 
 
25% increase in patients referred
annually
75% reduction in wait time since this
service strategy commenced.
2021 32% of patients were discharged
after one session
Assessment, treatment and education
at the earliest possible stage can
significantly reduce the ongoing
demand on ED physiotherapy
 
 
CHALLENGES
 
 
Advanced Practice Physiotherapy (APP) business
case has been developed and is awaiting
submission.
 
 
 
Caseload Management – 2 different clinical
areas
 
Acute MSK conditions – often same day injury
and assessment
 
 
VALUE TO THE PATIENTS
 
 
Patients are reviewed at initial presentation.
 
Patients are placed on appropriate treatment
pathway at the earliest possible stage and
recover quicker.
 
Patients have a greater understanding of their
condition.
 
Developed & maintained a significant
improvement in waiting time.
 
Self management strategies
 
Reduce re-presenation
 
SUSTAINMENT
Slide Note

The title of my presentation is Pandemic – Seizing the opportunity to improve a patients acute musculoskeletal Journey. In Beaumont ED per month there is on average 1200 MSK presentations per month and this takes up over 20% of the total ED hours available assessing this cohort of patients.

It takes a huge portion of the ED medical teams times managing these what some NCHD’s would call complex presentations giving their MSK background. Many of the NCHD’s would rather manage the medically unwell cohort of patients.

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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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  1. 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

  2. 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.

  3. 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%

  4. 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

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