Assessment of the Relevance of Integrating an Advanced Practice Physiotherapist in Emergency Departments in Belgium: A Qualitative Exploratory Study

This study aims to assess the relevance of integrating an APP in the emergency departments of French-speaking Belgium.

The methodology adopts a descriptive qualitative approach following an iterative process described by Hardig et al. and Brabo et al. : a focus group to identify the needs, roles, and competencies of the APP with 19 emergency physicians and nurses from three Belgian emergency departments (up to 50,000 contacts per year); the development of final care pathways for each institution; and the elaboration of the final APP framework based on a consensus between the three emergency departments using NVivo software.

Participants appeared favorable to the integration of an APP in their emergency departments, believing that this new healthcare professional might effectively contribute to improving care and optimizing resource use in emergency department organization. Two main advanced practice care pathways were described: a musculoskeletal pathway where the APP has full autonomy, and a respiratory pathway where the APP acts as an expert for specific procedures. The competencies necessary for the APP’s role include medical acts delegated from physicians including diagnostic procedures, referral to secondary care physicians, performing therapeutic medical procedures, and emergency care coordination in this context.

The iterative and rigorous methodology of the study ensures the reliability of the qualitative data, particularly through repeated validation of the results by the participants. APPs would enhance the efficiency of emergency care, addressing non-critical cases more promptly and appropriately. Our findings highlight the need for specialized training and certification for physiotherapists entering advanced practice roles.  The study’s findings align with measures already implemented in other countries. The study provides a theoretical basis for future research, such as a Delphi study to further define the roles and competencies of the APP in Belgium, and a pilot study to assess its implementation.

This study demonstrates the potential for integrating APPs into emergency departments in French-speaking Belgium.

From a policy standpoint, the study supports the formal recognition of APPs, encouraging healthcare regulators to establish guidelines for their integration into emergency teams.