Perceptions of emergency department staff of the role of physiotherapists in the system: a qualitative investigation

Abstract

Objectives: To investigate the perceptions of doctors, nurses and physiotherapists of emergency department physiotherapy for acute patients, and explore the scope of its contribution in an otherwise nontraditional allied health setting in Australia.

Design: Qualitative investigation using semi-structured interviews.

Setting: A large, metropolitan tertiary hospital with a well-established emergency department physiotherapy/allied health network in place.

Participants: Two emergency department doctors, two emergency department nurses and two senior physiotherapists working in an emergency department were recruited purposefully from the study hospital.

Interventions: Semi-structured interviews lasting from 20 minutes to 1 hour were conducted with each participant by the lead investigator. Data were analysed using NVivo software, coded manually and verified with member checking, facilitating constant case comparisons.

Results: Issues explored included defining the role of physiotherapists, uncovering organisational themes from the introduction of physiotherapy into the established emergency department setting, and conflicts around preserving and expanding an allied health identity in a highly-medicalised clinical environment.

Conclusions: Participants described the benefits of having physiotherapists located in the emergency department, and the physiotherapists were eager to advance their roles and responsibilities, but were, at times, restricted by a complicated organisational landscape influencing professional autonomy and capacity for professional advocacy. Ongoing evidence supporting the breadth of physiotherapy practice in the emergency department is needed to further advocate the usefulness of the profession in this acute setting.

Keywords: Case study; Emergency department; Emergency staff perceptions; Extended scope of practice; Physiotherapy.