ERs may benefit from addition of physiotherapist’s presence

Paul Mayne // Western NewsKinesiology student Emma Pearson said musculoskeletal injuries, such as injuries to discs, ligaments, muscles or tendons, could be better addressed in emergency rooms by physiotherapists, which would help reduce wait times and allow for quicker diagnosis and treatment options.

Reduced wait times, quicker diagnoses and faster prescribed treatments in Canada’s emergency rooms could be as simple as utilizing specialized health professionals, such as physiotherapists, according to one Western student.

Every day, more than 10,000 Canadians require medical attention due to an injury, with 93 per cent seeking help in emergency rooms. But with many presenting as musculoskeletal (MSK) injuries – those affecting body movements or the musculoskeletal system, such as blood vessels, discs, ligaments, muscles, tendons and nerves – many patients are ranked low on the triage scale and face increasingly long wait times before a diagnosis and treatment plan can be determined.

Kinesiology student Emma Pearson said MSK injuries can be difficult to deal with in an ER setting, because of the many demands physicians face. Of the injured Canadians over the age of 11 requiring medical attention for activity-limiting injuries, almost 75 per cent are within a physiotherapist’s scope of practice.
“Hiring physiotherapists to work in the ER could help free up time for physicians, as well decrease patient wait times,” said Pearson, who worked at the Ivey Centre for Health Innovation this past summer. “Someone like a physiotherapist, who is very specialized in MSK injuries, could do a lot of the work for those patients so the ER doctors don’t have to spend as much time on a patient. There would still have to be a physician involved, but just not as long.”

As a member of the Western Mustangs women’s hockey team, Pearson is familiar with the sort of injuries that can turn up in the ER. She is also familiar with the frustration of long wait times and not getting the needed answers after a visit to the ER.

“Something that is necessarily not as urgent, say back pain or a shoulder injury, but it (still) really affects that patient. Having someone there to give them solutions really helps a lot,” said Pearson. “They (patients) know there is something they can do immediately and not have to wait for another visit to be told.”

She cited a United Kingdom study which utilized extended scope physiotherapists (ESPs) in the ER for peripheral soft tissue injuries. These ESPs managed patients presenting with soft tissue injuries and associated fractures, and were able to request radiographs, prescribe limited medication and refer the patient to other services.

Patient satisfaction was found to be higher for patients treated by ESPs and these patients felt they received better advice about the injury, had time to ask questions and had a clear explanation of results of assessments and management plans.

“There was better patient satisfaction. They did get more time with someone, it just wasn’t a doctor,” said Pearson. “One of the problems is a lot of people go to the ER and they don’t get answers, a treatment plan or what they’re supposed to do. This creates more of a burden on the health-care system because they have to come back.”

She added Canada can learn from how the U.K. utilizes physiotherapists in their ERs to improve overall operations through reduced wait times, improved patient outcomes and increased patient satisfaction. Early intervention by a physiotherapist could allow for earlier diagnosis, and therefore, treatment, facilitating a smoother and quicker recovery.

“You need to spend money now. It needs to be an investment to help patient satisfaction and wait times,” said Pearson. “It enables the other doctors to see multiple patients, so that’s more efficient as well. So, putting certain patients into the scope of someone else who can work on it, who isn’t the doctor, would be really beneficial.”