The role for physiotherapists in the management of minor musculoskeletal injuries presenting to an emergency department : an evaluation of the physiotherapy service at the Emergency Department of Mater Dei Hospital

Abstract

BACKGROUND: Musculoskeletal injuries presenting to the emergency department are very common and a significant burden of work. This study aims to assess the impact of their management by musculoskeletal physiotherapists.

METHOD: A comparative analysis was selected with three outcomes to assess this impact: (1) patients’ total length of stay in the emergency department, (2) patients’ return rate with the same complaint, and (3) the referral rate to physiotherapy out-patients. Retrospective data of six months was collected from an electronic record of patients who presented with minor musculoskeletal injuries to the Emergency Department in Mater Dei Hospital, Malta.

RESULTS: Over a period of 6 months, 6087 patients with minor musculoskeletal complaints presented to the emergency department. Of these, 11% were managed by a physiotherapist who worked a limited total of 30 hours per week. The length of stay in the emergency department for patients managed by physiotherapists had a mean of 202 minutes and a mode of 99 minutes whilst that of doctors had a mean of 380 minutes and mode of 109 minutes. Of the patients who returned to the emergency department with the same complaint, 74% were managed by doctors only and 26% were managed together with the physiotherapist. Physiotherapists referred 26% of their patients for follow-up physiotherapy appointments whilst doctors referred only 11% of the patients.

CONCLUSION: Our study concludes that timely physiotherapy intervention in the Emergency Department for minor musculoskeletal cases contributes to a shorter length of stay, lower return rate, and more specific referrals to physiotherapy out-patients.