Orthopaedic triaging by podiatrists: a prospective study of patient satisfaction and service efficiency
Tom P. Walsh A B D , Dolores C. Pilkington A , Esther J. Wong A , Christopher H. Brown C and Graham E. Mercer CA Department of Podiatry, Repatriation General Hospital, Daws Road, Daw Park, SA 5041, Australia. Email: dolores.pilkington@health.sa.gov.au; esther.wong@health.sa.gov.au
B School of Medicine, Faculty of Medicine, Nursing and Health Sciences, Flinders University, Bedford Park, SA 5042, Australia.
C Department of Orthopaedic Surgery, Repatriation General Hospital, Daws Road, Daw Park, SA 5041, Australia. Email: chris@orthofoot.com.au; graham.mercer@health.sa.gov.au
D Corresponding author. Email: tom.walsh@health.sa.gov.au
Australian Health Review 38(4) 406-411 https://doi.org/10.1071/AH13243
Submitted: 19 December 2013 Accepted: 10 March 2014 Published: 29 May 2014
Abstract
Background The Southern Adelaide Local Health Network is serviced by one orthopaedic surgeon specialising in foot and ankle surgery. In 2011, the waiting list to see the surgeon was expanding and the need for assistance was growing. The Department of Podiatry agreed to provide a podiatrist to assist in the management of the outpatient waiting list. Although patient outcome is an important outcome measure, we were interested in evaluating the service with respect to how satisfied patients were with seeing a podiatrist. Therefore, the primary aim of the study was to evaluate patient satisfaction with podiatry-led clinics for the orthopaedic outpatient waiting list. Secondary outcomes included discharge rate and efficiency of care.
Methods We prospectively recruited a consecutive sample discharged from the Department of Podiatry between 1 May and 1 November 2013 to complete the Client Satisfaction Survey (CSQ-8). This survey was used to evaluate the satisfaction of patients following discharge from the Department of Podiatry.
Results There were 49 patients (16 men, 33 women) enrolled in the survey during the 6-month period. Of the 49 patients discharged, 21 (43%) were discharged from the outpatient waiting list. Twenty-eight patients (57%) were referred on to the Department of Orthopaedic Surgery for opinion and management. The mean (± s.d.) number of appointments for each patient was 1.3 ± 0.6. Overall, patients were very satisfied with the assessment and/or treatment they received.
Conclusion A podiatrist, working at an extended scope of practice and in collaboration with an orthopaedic surgeon, can successfully and efficiently assess and treat patients on an orthopaedic outpatient waiting list. Patients generally reported a high level of satisfaction with the process and would return to the clinic again if necessary. Hospital networks wanting to efficiently reduce waiting lists may endorse task substitution for appropriately skilled podiatrists.
What is known about the topic? Allied health professionals have acted in extended scope of practice roles across several professions. These roles are often implemented in response to long waiting lists to see medical specialists. The acceptance of these practitioners by patients and the efficiency of these clinics are yet to be formally evaluated.
What does the paper add? This paper should provide confidence in implementing orthopaedic triaging roles for podiatrists. High satisfaction rates were noted, along with an efficient service, both of which may be attractive for hospital networks.
What are the implications for practitioners? Extended scope of practice podiatry roles may be implemented to assist in managing orthopaedic outpatient waiting lists.
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