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DEMAND MANAGEMENT IN PAEDIATRIC ORTHOPAEDICS – IS A PHYSIOTHERAPY SPECIALIST CLINIC USEFUL?



Abstract

An audit of general practitioner (GP) Paediatric orthopaedic referrals to our hospital (1996) revealed that the average waiting time was 84 weeks for non-urgent simple conditions. A physiotherapy specialist clinic was set up to reduce waiting times for non-urgent, new general practitioner Paediatric Orthopaedic referrals.

To review the outcome at a minimum of 12 months of 1046 consecutive referrals to the Physiotherapy Specialist clinic and to analyse its effectiveness.

114 patients failed to attend the clinic. The remaining 932 patients form the basis of this study. Outcome measures included reduction in the waiting times, patient satisfaction, number of re-referrals to the clinic from the general practitioners and cost-effectiveness. 93% of these patients were managed without direct consultant intervention 71. 6% with advice and reassurance, 16. 9% by referral to the physiotherapy department and 4% with surgical appliances. Only 7% needed consultant evaluation. Waiting time for non-urgent conditions was reduced from 84 weeks in May 1996 to 5 weeks in May 1999. A majority of the parents were satisfied with the clinic. The clinic was found to be cost-effective.

The physiotherapy specialist clinic was effective in reducing waiting times for new non-urgent Paediatric Orthopaedic referrals. The success of the clinic was attributable to good co-operation between the consultant and physiotherapist and a well-defined protocol for assessment and management of patients.

The abstracts were prepared by Mr Simon Donell. Correspondence should be addressed to him at the Department of Orthopaedics, Norfolk & Norwich Hospital, Level 4, Centre Block, Colney Lane, Norwich NR4 7UY, United Kingdom