On call physiotherapy: the impact of outreach services

The Modified Early Warning System (MEWS) was introduced in 1998 to aid in the detection of critical illness within the ward setting. Strong links were forged between outreach, physiotherapy and surgery from 1998, as the critical care physiotherapist covered both areas. Formalisation of multidisciplinary outreach was achieved in June 2001, with the appointment of an outreach physiotherapist whose role includes not only critical care patients, but also hospital-wide, ward-based, outreach. Retrospective audit data on frequency of callout by speciality was collected over 4 month snapshot periods (April, May, June, and July) for the years 1999–2002 in order to analyse outreach physiotherapy impact on emergency physiotherapy callouts.

The hospital has a total of 575 beds, of these 424 are inpatient with 60 acute surgical and 114 acute medicine. The majority of callouts were to the acute surgical wards (142) in contrast to acute medicine (42). Evening callouts to acute surgery showed a consistent decline, as did the frequency of weekend daytime on call requests. This finding is not surprising, as multidisciplinary outreach intervention has been embraced primarily within surgery. Figure 1 demonstrates the reduction in callouts over the past 4 years. Further audit over the winter period is necessary.

Figure 1

Monitoring the number of out-of-hours physiotherapy callouts is one way of assessing the impact of specific physiotherapist roles within outreach.