Perception and Knowledge of Healthcare Workers Towards “Emergency Department Physiotherapy”

Abstract

Introduction: Addition of physiotherapists in Emergency Departments (ED) as first-contact treating practitioners can be taken as a useful asset. However, some hospitals lack dedicated Physiotherapists in ED. Aim and Objectives: This study aimed to explore the knowledge and perceptions of healthcare workers (HCWs) towards Emergency Department Physiotherapy (EDP), assess the current staffing composition in ED, and determine the perceived need for the placement of physiotherapists in these settings. Objectives included: determine current staffing composition in Gauteng ED, identifying the need of physiotherapist placement, and determine HCW & physiotherapists’ knowledge and perceptions towards EDP. Methodology: A quantitative cross-sectional study was conducted using an electronic questionnaire (RedCap) & a retrospective review of patient records from 01/01/2023 to 31/12/2023. Results: ED staff in Gauteng hospitals are composed of doctors, nurses, physiotherapists, clinical & therapeutic, and support staff (20 ED managers responses). Higher-level hospitals had greater staffing numbers (e.g., central hospital n=557,72%). A total of 2,242 clinical files were reviewed from 4 EDs (1 ED per category of hospital). Common ED diagnoses included pain (30%), soft tissue injuries (26%), respiratory issues (14%), neurological conditions (9%), and fractures (6%). Notably, 73% (n=1,641) of records with conditions suitable for physiotherapy were not referred. Only 4% of ED cases were screened by physiotherapists, while 23% were referred. Among ED managers, 20% recommended adding physiotherapists to ED, and 95% supported awareness campaigns on physiotherapy roles. Among HCWs, 73% (doctors and nurses) had never heard of EDP, 81% reported its absence in their facilities, and 62% expressed the need for dedicated EDP posts. HCWs identified key physiotherapy roles such as chest physiotherapy, walking aid provision, early mobilization, acute respiratory care, and orthopaedic/trauma management. Over 50% believed EDP could reduce waiting times, improve care quality, enhance early intervention, reduce inappropriate referrals, and optimize resource use. Among physiotherapists, 76% had some interaction with ED, 83% were not trained in EDP, and 88% indicated a need for such training. About 47% of referred patients were treated in ED. Physiotherapists reported attending to patients needing urgent stabilization to prevent hospitalization and promote recovery. Conclusion: EDP plays a vital role in ED. There is a clear need for increased awareness, education, training, and the strategic placement of physiotherapists in ED. Both HCWs and physiotherapists recognize the value & importance of EDP in improving emergency care outcomes. The study also lays the groundwork for future research and benchmarking, both locally and internationally, in the development and implementation of EDP.