An evaluation of the physiotherapy on-call service in St. Luke's Hospital.

Abstract

The purpose of this study was to evaluate the physiotherapy on-call service at St Luke's Hospital (SLH), which aims to offer physiotherapy services to patients at risk of deterioration in their condition. The views of doctors who refer patients for physiotherapy on-call were sought. Physiotherapists' perceptions regarding their competence to provide the on-call service was also determined. Competence of the work force acts as an indicator to quality of care provided. Physiotherapists' preparation through induction to the on-call service, and on-going support were also addressed. The viewpoint of both doctors and physiotherapists regarding justification of patient referral was reviewed. The financial cost of running the service was calculated. Questionnaires were used in this quantitative, cross-sectional survey. Physiotherapists' questionnaires were distributed to the whole population (n=29) of physiotherapists participating in on-calls and had a response rate of 93%. The doctors' questionnaire was distributed to a 50% sample of Senior Registrars and Senior House Officers, that was generated by computer randomisation: the response rate was 75%. SPSS version 11.0 was used in the descriptive analysis. It was concluded that doctors' awareness regarding the role of the physiotherapist on-call together with the service, needs to be improved: protocols and guidelines for doctors will make more efficient use of the service. Communication between the two professions has to be imp1 oved since both doctors and physiotherapists felt that liaison was insufficient. Improper communication led to unjustified patient referrals in certain situations, since physiotherapists thought that on most occasions ( 48.2%.) they were called to see a patient in the night, their intervention was not indicated. Although most physiotherapists felt competent to work in critical care units (major sources of patient referrals), they recognised further learning needs and on-going support from senior staff when working on-calls. Standards are necessary to allow the formal assessment of physiotherapists' competence. Further research is necessary to explore in depth the perceptions of doctors and physiotherapists. Also the quality of care needs to be audited, and the cost-effectiveness of running the service has to be analysed.