Evaluation of an Advanced-Practice Physical Therapist in a Specialty Shoulder Clinic: Diagnostic Agreement and Effect on Wait Times.
Purpose: To examine the role of an advanced-practice physiotherapist (APP) with respect to (1) agreement with an orthopaedic surgeon on diagnosis and management of patients with shoulder problems; (2) wait times; and (3) satisfaction with care. Methods: This prospective study involved patients with...
| Publicado en: | Physiotherapy Canada Vol. 65; no. 1; pp. 46 - 56 |
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| Autores principales: | , , , , , |
| Formato: | forms research tables/charts Journal Article |
| Publicado: |
University of Toronto Press
2013
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104315629&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104315629 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 03000508 R42 jtl: Physiotherapy Canada issn: 03000508 maglogo: N pubinfo: dt: 2013 vid: 65 iid: 1 pid: 678 pub: University of Toronto Press place: North York, Ontario artinfo: ui: 104315629 85147775 85147775 10.3138/ptc.2011-56 NLM24381382 PMC3563377 104315629 ppf: 46 ppct: 10 formats: fmt: @attributes: type: P tig: atl: Evaluation of an Advanced-Practice Physical Therapist in a Specialty Shoulder Clinic: Diagnostic Agreement and Effect on Wait Times. aug: au: Razmjou, Helen Robarts, Susan Kennedy, Deborah McKnight, Cheryl MacLeod, Anne Marie Holtby, Richard affil: Holland Orthopaedic & Arthritic Centre, Sunnybrook Health Sciences Centre sug: subj: Physical Therapy Shoulder Pain Etiology Shoulder Pain Therapy Patient Satisfaction Treatment Delay Orthopedic Surgery Shoulder Injuries Diagnosis Shoulder Injuries Therapy Professional Role Human Funding Source Canada Prospective Studies Comparative Studies Shoulder Injuries Surgery kappa Statistic Nonparametric Statistics Confidence Intervals Clinical Assessment Tools Reliability and Validity Wilcoxon Signed Rank Test Male Female Young Adult Adult Middle Age Aged Aged, 80 and Over Chi Square Test Interrater Reliability Descriptive Statistics Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over Male Female ab: Purpose: To examine the role of an advanced-practice physiotherapist (APP) with respect to (1) agreement with an orthopaedic surgeon on diagnosis and management of patients with shoulder problems; (2) wait times; and (3) satisfaction with care. Methods: This prospective study involved patients with shoulder complaints who were referred to a shoulder specialist in a tertiary care centre. Agreement was examined on seven major diagnostic categories, need for further examination and surgery, and type of surgical procedure. Wait times were compared between the APP- and surgeon-led clinics from referral date to date of initial consultation, date of final diagnostic test, and date of confirmed diagnosis and planned treatment. A modified and validated version of the Visit-Specific Satisfaction Instrument assessed satisfaction in seven domains. Kappa (κ) coefficients and bias- and prevalence-adjusted kappa (PABAK) values were calculated, and strength of agreement was categorized. Wait time and satisfaction data were examined using non-parametric statistics. Results: Agreement on major diagnostic categories varied from 0.68 (good) to 0.96 (excellent). Agreement with respect to indication for surgery was κ=0.75, p<0.001; 95% CI, 0.62-0.88 (good). Wait time for APP assessment was significantly shorter than wait time for surgeon consultation at all time points (p<0.001); the surgeon's wait time was significantly reduced over 3 years. High satisfaction was reported in all components of care received from both health care providers. Conclusions: Using experienced physiotherapists in an extended role reduces wait times without compromising patient clinical management and overall satisfaction. pubtype: Academic Journal doctype: forms research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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