Development, implementation and evaluation of an advanced practice in continence and women's health physiotherapy model of care.

Abstract

With public health facing workforce shortages, increasing costs and increasing demands, innovative patient pathways are vital to meet patient needs. Advanced practice physiotherapy roles are well established in emergency departments and musculoskeletal/orthopaedic services and have begun to emerge in other clinical areas. In 2014, the Royal Women's Hospital, Monash Health and Barwon Health received a Victorian Department of Health and Human Services (DHHS) Workforce Innovation grant to develop and implement an advanced practice in continence and women's health physiotherapy assessment model of care. A new model of care was developed with an advanced practice physiotherapy-led assessment clinic integrated into the triage and assessment process of gynaecology, urogynaecology and urology clinics in major public health centres. A clinical competency and credentialing pathway and toolkit were developed to support training and development of advanced practice skills for senior physiotherapists in this clinical area. The initial assessment of the new model of care was undertaken by DHHS and Price-Waterhouse Coopers, including access to care, cost of assessment and safety. An advanced practice continence and women's health physiotherapy assessment clinic was implemented safely and contributed to improved access to care as assessed by reduced waiting lists and waiting times for assessment, with high levels of patient satisfaction and no adverse events. Advanced practice continence and women's health physiotherapy clinics can contribute to streamlined, cost-efficient triage and assessment processes for patients with urological or gynaecological issues attending tertiary medical clinics.