Advanced practice physiotherapy in paediatrics: Implementation results

Abstract

Objectives This study aimed to evaluate the implementation of an advanced practice physiotherapist (APP) clinic in our paediatric institution and assess APP and orthopaedic surgeon satisfaction. Methods In this retrospective cohort study, all patient records from the APP clinic’s second year (March 2017 to March 2018) at CHU Sainte-Justine were reviewed. These were compared with the records of patients seen by orthopaedic surgeons within the gait clinic the year before implementing the clinic. The following data were collected: demographic, professional issuing referral, reason for referral, consultation delay, clinical impression, investigation, and treatment plan. We also documented every subsequent follow-up to rule out any diagnostic change and identify surgical patients. Clinician satisfaction was assessed by the Minnesota Satisfaction and PROBES Questionnaires along with a short electronic survey. Results Four hundred and eighteen patients were assessed by APPs and 202 by orthopaedic surgeons. APPs managed patients independently in 92.6% of cases. Nearly 86% of patients were discharged following the initial visit, and 7.4% were referred to a physiotherapist. Only 1% of APP patients eventually required surgery compared with nearly 6% in the orthopaedic group. The mean waiting time for consultation was greater in the APP group (513.7 versus 264 days). However, there was a significant reduction in mean waiting time over the last 3 months surveyed (106.5 days). Conclusions The feedback from all clinicians involved was positive, with a greater mean score on the Minnesota Satisfaction and PROBES Questionnaire for APPs. The APP gait clinic appears to be an effective triage clinic. Level of evidence III

Understanding the Perspectives of Paediatric Physicians on Physiotherapy in Paediatric Rehabilitation in Chennai, India: A Qualitative Approach

“…This improves not only the emotional bonding between parent and child but also the parents’ awareness of the physiotherapy treatment’s approaches, thereby improving adherence [ 7 , 23 - 25 ]. Fifth, paediatric physicians prioritize those paediatric physiotherapists who have more skills, are up to date with recent trends, and are well versed with evidenced-based practice over physiotherapists with basic levels of experience and innovation [ 1 , 26 ].…”

“…Physiotherapy has been widely accepted as a crucial part of disability rehabilitation for children, with its diagnostic accuracy, treatment strategies, and patient outcomes considered on par with medical treatment [ 1 , 2 ]. As various studies have highlighted, physiotherapy consistently contributes to increasing the independence of children with various neuromuscular conditions, cardiorespiratory distress, and orthopaedic conditions, and a financial analysis has reported it to be cost-effective in financial analysis [ 1 , 3 ].…”