A national workforce analysis of physiotherapy practice in Australian emergency departments

Emergency Department (ED) physiotherapy in Australia has evolved over the past decade from in-reach aged care coordination and secondary contact roles to larger, more autonomous roles. This evolution has been influenced by societal, economic and political pressure with research predominantly focused on specific aspects of an ED physiotherapist’s role within a limited number of EDs rather than a holistic, national level evaluation of the role and scope of practice. Despite the introduction of national registration for physiotherapists and specialist clinical streams, little is known regarding the ED physiotherapy workforce nationally. To fully understand the current breadth of practice and benefits of ED physiotherapy there is an obvious need to provide a well-defined and detailed description of ED physiotherapy practice in Australia. In order to address this, this thesis details the results of a nation-wide survey of 94 ED physiotherapists and provides detailed workforce data, evaluates current scope of practice, and explores perceptions of factors influencing the current and future role of ED physiotherapy.

Despite the lack of a national framework, ED physiotherapy practice in Australian has evolved to that with autonomous responsibility for identifying suitable patients, providing the necessary care and facilitating appropriate discharge. ED physiotherapists were found to be experienced and highly trained clinicians with a generalist scope, often working as primary contact clinicians with seven day a week coverage that was mainly provided during daytime hours. Despite being predominantly in primary contact roles, they continue to provide care in a secondary contact capacity when required. They were found to be integrated and valued members of the ED team who interact with a variety of ED stakeholders, with the role influenced and impacted by levers at all levels of the health system. However, there is scope to improve the contribution of ED physiotherapy and the alignment with the demands of ED and the health system by adopting a change approach that embraces ED physiotherapists as existing within a complex adaptive system.