Objectives
Extended Scope /Advanced Practice Physiotherapy (APP) ‘triage’ clinics have developed throughout the UK and Ireland in response to expanding waiting lists with concurrent increase in wait times for elective orthopaedic patients. While there has been much evaluation of adult patient satisfaction (Oakley et al, 2015), there are no similar studies in the paediatric literature. The development of APP services in paediatric orthopaedics represents a shift in service delivery, and while it has shown marked wait time reduction and good care-pathway outcomes for patients (O Mir, 2016), it is important to evaluate satisfaction, as service user ‘buy-in’ is essential for a new model of care to be accepted. The objective of this study is to evaluate the satisfaction of parents of patients attending an APP paediatric orthopaedic clinic by examining perceptions of their experience.
Method
This is a prospective multi-strategy study using a concurrent triangulation design. Two hundred sequential patients and their parents were invited to participate over a four month period. Data was collected using a modified version of the Visit Specific Satisfaction Questionnaire (VSQ-9) and an open-ended comment section. VSQ-9 ratings were transformed to a linear scale as per recommendations and analysed using descriptive statistics. Cronbach’s Alpha was performed to evaluate internal consistency of the survey tool in the population.
Qualitative analysis was designed to meet COREQ standard. An inductive method of content analysis with open coding was utilised by 2 independent assessors to generate themes.
Results
A total of 167 out of 200 respondents completed the questionnaire (response rate 85%) with 72 providing additional comments. Satisfaction ratings were excellent with a mean total score of 95.3 (95% CI: 93.4 – 97.2). Cronbach’s alpha coefficient was .85 indicating high internal consistency for the modified VSQ-9 when administered in an Irish Paediatric setting.
Emergent themes were identified as Time, Communication, Professionalism, Service Delivery and Physical Resources. Professionalism was ranked highest of all themes and surveyed items. The term “Excellent” was the single most common term used
Conclusions
To our knowledge, this is the first study to examine parental satisfaction with APP clinic in paediatric orthopaedics.
Parents are very satisfied with an APP clinic as first point of contact for paediatric orthopaedic assessment in a specialist tertiary centre. On the whole parents described their experience in positive terms and this was duplicated in the very high satisfaction ratings on the VSQ-9
The high satisfaction levels reported, has very important implications for planning and delivery of future healthcare services with a patient-centred care focus. The study also identified the themes that most impact on parental perceptions of quality of care and satisfaction in a paediatric outpatient setting.
References
Oakley, C. and Shacklady, C., 2015. The Clinical Effectiveness of the Extended‐Scope Physiotherapist Role in Musculoskeletal Triage: A Systematic Review. Musculoskeletal care, 13(4), pp.204-221.
Mir, M.O., Cooney, C., O’Sullivan, C., Blake, C., Kelly, P., Kiely, P., Noel, J. and Moore, D., 2016. The efficacy of an extended scope physiotherapy clinic in paediatric orthopaedics. Journal of children's orthopaedics, 10(2), pp.169-175.
Ethical Approval
Ethical approval for this study has been granted by Our Lady’s Childrens’ HospitalEthics (Medical Research) Committee.
Musculoskeletal , Paediatrics , Service Development
