Physiotherapist-Led Triage Within Orthopaedic Spine Consultation: Evaluation of a Novel Secondary Care Model of Care
Date
Authors
Chauhan, Rohil
Kheterpal, Aanirudh
Segar, Anand
Supervisor
Item type
Journal Article
Degree name
Journal Title
Journal ISSN
Volume Title
Publisher
New Zealand Medical Association
Abstract
Aim: Timely access for orthopaedic spine consultation remains a challenge due to increasing demand and workforce constraints. Integrating advanced physiotherapy consultation models within orthopaedic services is an emerging strategy to streamline care. While common in New Zealand’s tertiary care sector, comparable models in secondary care are lacking. This study evaluated the outcomes of a novel physiotherapist-integrated orthopaedic consultation model in secondary care. Methods: A retrospective review of patients seen from March to July 2023 was conducted using a five-step physiotherapist-integrated orthopaedic consultation model to assess management decisions, patient satisfaction, impact on consultation wait times and service capacity, and diagnostic concordance. Results: Among 233 patients (mean age 46.8 years; 53.6% male), 73.4% presented with lower back and associated lower limb symptoms. Most (74.7%) were managed non-operatively, 25.3% underwent surgical workup and 10.7% proceeded to surgery. Patient satisfaction was high (overall mean 91.3%), with highest scores for quality of care (92.3%) and explanation of treatment/expected outcomes (91.7%). While mean consultation wait times were longer than the 2021 pre-model cohort (63 vs 47.4 days), service capacity increased by 32%. Across three magnetic resonance imaging variables, diagnostic concordance was substantial (overall agreement: 78.1%; mean kappa: 0.65 [0.63–0.68]). Conclusion: A physiotherapist-integrated orthopaedic consultation model in secondary care is highly accepted by patients, increases service capacity and broadens multidisciplinary decision-making capacity. While a model as such is theoretically positioned to reduce consultation wait times, this was not observed in the present analysis—reflecting a growing unmet need for orthopaedic consultation in secondary care.Description
Keywords
32 Biomedical and Clinical Sciences, 3202 Clinical Sciences, 42 Health Sciences, Health Services, Clinical Research, Musculoskeletal, 3 Good Health and Well Being, 11 Medical and Health Sciences, General & Internal Medicine, 32 Biomedical and clinical sciences, 42 Health sciences
Source
New Zealand Medical Journal, ISSN: 0028-8446 (Print); 1175-8716 (Online), New Zealand Medical Association, 139(1633), 65-75. doi: 10.26635/6965.7289
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Open Access. The NZMJ is fully available to individual subscribers and does not incur a subscription fee.