Musculoskeletal Physiotherapy in the Emergency Department Evaluation of a New Physiotherapy Service in a Swiss University Hospital

ABSTRACT
Background Many countries report a significant increase in
emergency department (ED) visits. Patients with musculoskeletal disorders account for a large proportion of non-urgent
cases.
Objective Characterization and evaluation of a new service
that provides immediate access to physiotherapy for patients
in the ED.
Method To characterize a new service at the Department
of Emergency Medicine, Bern University Hospital, and to
evaluate first experiences with it, a mixed methods approach
was chosen. Data was collected from the electronic patient
file and from a logbook kept by the physiotherapists. In addition, guideline-based interviews with involved health care
staff were conducted.
Results During the 63 days of the pilot study 79 patients
were treated by physiotherapists. The most frequently reported patient complaint was back pain (47 %). Interventions included taking the medical history, performing manual tests
and multimodal treatment and developing recommendations
for further treatment. In 59 % of patients no medical imaging
and in 58 % no additional physiotherapy was prescribed.
Patients rated the physiotherapeutic service as very good or
excellent (88 %). Physiotherapy was experienced as positive
and appreciated by the other professions, and all interviewees
emphasized the added value for patients.
Conclusion The pilot study indicates that the physiotherapeutic consultation service has the potential to improve quality of care. The findings of this study are therefore valuable
when considering the introduction of such a service in an ED.

ZUSAMMENFASSUNG
Hintergrund Viele Länder berichten über einen signifikanten
Anstieg von Behandlungen in der Notaufnahme. Patient*innen mit muskuloskelettalen Erkrankungen machen einen
großen Anteil der nicht dringenden Fälle aus.
Ziel Charakterisierung und Evaluation eines neuen Dienstes,
der Patient*innen in der Notaufnahme einen sofor tigen
Zugang zur Physiotherapie bietet.
Methode Um den neuen Dienst im Notfallzentrum des
Universitätsspitals Bern zu charakterisieren und erste Erfahrungen zu evaluieren, wurde ein gemischter methodischer
Ansatz gewählt. Dabei wurden Daten aus der elektronischen
Patientenakte und aus einem von Physiotherapeut*innen geführten Logbuch gesammelt. Zusätzlich wurden Leitfaden
gestützte Interviews mit involvierten Gesundheitsfachpersonen durchgeführt.
Ergebnisse Während der 63 Tage der Pilotstudie wurden
79 Patient*innen von Physiotherapeut*innen behandelt.