The 'lone ranger': a descriptive study of physiotherapy practice in Australian emergency departments

Abstract

Objectives: Physiotherapy services have recently been introduced to Australian emergency departments in an attempt to address service delivery issues such as access block. This study aimed to determine the roles, including those relating to extended scope practice, currently undertaken by physiotherapists in Australian emergency departments.

Design: Descriptive cross-sectional design. An Internet-based survey, containing 37 items to access demographic and perceptual data, was distributed to Australian emergency department physiotherapists between 8 February and 30 April 2009. Twenty-eight of these questions generated categorical data, which were analysed using frequency distributions. Thematic analysis was undertaken for the nine questions that generated text responses.

Participants: Participants were included if they were registered Australian physiotherapists working in an emergency department as part of the multidisciplinary team, and did not provide on-call service to the emergency department. Twenty-eight Australian emergency department physiotherapists met the inclusion criteria and completed the survey.

Results: The respondents were predominantly females working on a full-time basis in the emergency department. Responses indicated that the role is subject to time pressures with an emphasis on diagnosis and discharge planning. One respondent described emergency department physiotherapists as 'lone rangers' due to their autonomous work. Australian emergency department physiotherapists are not currently performing extended scope tasks, as many are prohibited under Australian legislation, but it is also unclear which tasks might be classified as extended scope.

Conclusion: Australian emergency department physiotherapists currently perform traditional physiotherapy roles in a non-traditional work environment. The role is aligned with musculoskeletal physiotherapy; however, there is a degree of holistic care involved, particularly for elderly patients. The effect that an emergency department physiotherapy service has on health outcomes is not known, but the study participants indicated that they believe their service has system-wide benefits.