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Cooper K1, Morrison L2, Paul A3, Alexander L1
1Robert Gordon University, School of Health Sciences, Aberdeen, United Kingdom, 2NHS Grampian, Aberdeen City Health & Social Care Partnership, Aberdeen, United Kingdom, 3NHS Grampian, Physiotherapy Services, Aberdeen, United Kingdom
Background: Telephone consultations are becoming more common in outpatient musculoskeletal (MSK) physiotherapy services for a number of reasons, including ensuring equity of access in remote/rural locations and providing timely assessment and advice in response to long waiting times. Conducting telephone consultations arguably requires a different skill-set from those traditionally employed by physiotherapists in face-to-face consultations, with many physiotherapists reporting less confidence conducting telephone consultations. There is little published work to date on training and supporting health professionals to undertake telephone consultations: a few studies on out-of-hours primary care services, and one UK-based study on training physiotherapists to deliver a specific telephone assessment and advice service were located.
Purpose: To explore patients' and physiotherapists' perceptions of outpatient MSK physiotherapy telephone consultations in order to inform the design of a training programme for physiotherapists.
Methods: This was a mixed-methods study where we:
(i) undertook a scoping review of literature pertaining to telephone consultations and training professionals to undertake them (reported elsewhere), and
(ii) conducted semi-structured qualitative telephone interviews with physiotherapists with experience of conducting telephone consultations and people who had received a telephone consultation in the previous 3 months. Data were analysed by two members of the study team using thematic analysis.
Results: Ten physiotherapists (mean age 34, 90% female) and 21 people who had experienced telephone consultations (mean age 50, 62% female) provided informed consent and took part in telephone interviews. Patients' and physiotherapists' data were broadly similar and five key themes emerged from the data:
(i) Importance of good communication;
(ii) practicalities of the telephone consultation;
(iii) delivering a good service;
(iv) physiotherapist factors, and
(v) training for telephone consultations.
A model of “the good telephone consultation” from patients' and physiotherapists' perspectives was proposed and consists of:
(i) appropriate facilities & reliable method of contact;
(ii) robust processes before, during and after the consultation;
(iii) knowledgeable, experienced & well-supported physiotherapists and the “right” patients; and
(iv) good patient-therapist & multi-disciplinary team communication.
It is proposed that the model should be underpinned by appropriate training and continuous professional development for physiotherapists in service delivery, communication skills, and conducting a good telephone consultation.
Conclusion(s): Important dimensions of MSK physiotherapy telephone consultations were identified by both patients and physiotherapists. Whilst it could be argued that the dimensions are broadly applicable to traditional face-to-face consultations, the findings suggest that consideration of these dimensions within the specific context of the telephone consultation is important for the delivery of high quality patient-centred care.
Implications: The findings can be used by physiotherapists to inform their conduct of telephone consultations in MSK physiotherapy. The findings will also have relevance to telephone consultations in other clinical areas and settings. In combination with the findings from our scoping review, we have developed a training package for physiotherapists new to telephone consultations, and a continuous professional development package for those with more experience. The packages will be tested throughout one Scottish health board area.
Keywords: Telephone consultations, Musculoskeletal, Systematic Review
Funding acknowledgements: NHS Grampian Endowment Research Grant 2017 (16/11/042)
Purpose: To explore patients' and physiotherapists' perceptions of outpatient MSK physiotherapy telephone consultations in order to inform the design of a training programme for physiotherapists.
Methods: This was a mixed-methods study where we:
(i) undertook a scoping review of literature pertaining to telephone consultations and training professionals to undertake them (reported elsewhere), and
(ii) conducted semi-structured qualitative telephone interviews with physiotherapists with experience of conducting telephone consultations and people who had received a telephone consultation in the previous 3 months. Data were analysed by two members of the study team using thematic analysis.
Results: Ten physiotherapists (mean age 34, 90% female) and 21 people who had experienced telephone consultations (mean age 50, 62% female) provided informed consent and took part in telephone interviews. Patients' and physiotherapists' data were broadly similar and five key themes emerged from the data:
(i) Importance of good communication;
(ii) practicalities of the telephone consultation;
(iii) delivering a good service;
(iv) physiotherapist factors, and
(v) training for telephone consultations.
A model of “the good telephone consultation” from patients' and physiotherapists' perspectives was proposed and consists of:
(i) appropriate facilities & reliable method of contact;
(ii) robust processes before, during and after the consultation;
(iii) knowledgeable, experienced & well-supported physiotherapists and the “right” patients; and
(iv) good patient-therapist & multi-disciplinary team communication.
It is proposed that the model should be underpinned by appropriate training and continuous professional development for physiotherapists in service delivery, communication skills, and conducting a good telephone consultation.
Conclusion(s): Important dimensions of MSK physiotherapy telephone consultations were identified by both patients and physiotherapists. Whilst it could be argued that the dimensions are broadly applicable to traditional face-to-face consultations, the findings suggest that consideration of these dimensions within the specific context of the telephone consultation is important for the delivery of high quality patient-centred care.
Implications: The findings can be used by physiotherapists to inform their conduct of telephone consultations in MSK physiotherapy. The findings will also have relevance to telephone consultations in other clinical areas and settings. In combination with the findings from our scoping review, we have developed a training package for physiotherapists new to telephone consultations, and a continuous professional development package for those with more experience. The packages will be tested throughout one Scottish health board area.
Keywords: Telephone consultations, Musculoskeletal, Systematic Review
Funding acknowledgements: NHS Grampian Endowment Research Grant 2017 (16/11/042)
Topic: Musculoskeletal; Education: continuing professional development
Ethics approval required: Yes
Institution: NHS Health Research Authority
Ethics committee: London-Brent Research Ethics Committee
Ethics number: 17/LO/1224
All authors, affiliations and abstracts have been published as submitted.
