O Mir M.1,2, Cooney C.1, O' Sullivan C.3
1Our Lady's Children's Hospital, Crumlin, Physiotherapy, Dublin, Ireland, 2University College Dublin, Physiotherapy, Dublin, Ireland, 3University College Dublin, School of Public Health, Physiotherapy and Sports Science, Dublin, Ireland
Background: 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, 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, it is important to evaluate satisfaction, as service user 'buy-in' is essential for a new model of care to be accepted.
Purpose: To evaluate the satisfaction of parents of patients attending an APP paediatric orthopaedic clinic by examining perceptions of their experience.
Methods: 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. Qualitative analysis was designed to meet COREQ standard. An inductive method of content analysis with open coding was chosen as most appropriate.
Results: A total of 167 out of 200 respondents completed the questionnaire (response rate 85%). The mean age of patient was 7.4 years (SD 4.6 years), with an equal male to female ratio. Satisfaction ratings were very high with a mean total score of 93.4 (SD 9.3). 72 participants provided comments. Once saturation was reached, identified themes were further categeorised into positive and negative aspects of the experience. These were triangulated against the quantitative data to enhance credibility and validity of the findings. The single term excellent was that most frequently used.
Conclusion(s): Parents are very satisfied with an APP clinic as first point of contact for paediatric orthopaedic assessment in a specialist tertiary centre. The positive themes were The personal attributes of the Physiotherapist, The manner in which the physiotherapist related to the child and Service Delivery . Negative themes were identifed as long wait times in clinic and Poor Facilities. On the whole parents described their experience in positive terms and this was duplicated in the very high satisfaction ratings on the VSQ-9.
Implications: To our knowledge, this is the first study to examine parental satisfaction with APP clinic in paediatic orthopaedics. 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.
It is very encouraging that satisfaction with the clinic is so high, considering this is the index clinic of its type in our healthcare system nationally. Further studies are planned to evaluate satisfaction amongst other key stakeholders i.e referring healthcare providers and consultant orthopaedic surgeons.
Funding acknowledgements: none
Topic: Paediatrics
Ethics approval: Ethical approval was received from Research and Medical Ethics committee of OLCHC, Dublin, Ireland
All authors, affiliations and abstracts have been published as submitted.
