Project Report

Implementation of an expanded-scope-of-practice physiotherapist role in a regional hospital emergency department


Donna Goodman1 PhD, Executive Director Allied Health

Desley Harvey2 PhD, Principal Research Fellow *

Tania Cavanagh3 B Physiotherapy, Director of Physiotherapy

Rebecca Nieman4 B Physiotherapy, Senior physiotherapy


1, 2, 3, 4 Cairns and Hinterland Hospital and Health Service, Cairns, Qld, Australia

ACCEPTED: 13 July 2017

early abstract:

Objective: The aim of the present study was to describe the implementation of an expanded scope physiotherapy service in a regional hospital emergency department (ED) and discuss the lessons learnt in terms of long term sustainability of these roles in regional areas.
Methods: The existing ED advanced physiotherapist was trained in extended scope of practice skills. For sustainability, a senior physiotherapist was recruited to develop further ED practice skills through a locally developed professional development package and ultimately be eligible to complete extended scope training. Mixed methods data collection included document review, patient and staff satisfaction surveys, and data mining of routine clinical data sets.
Results: The extended hours service operated for 12 months. The advanced physiotherapist completed post graduate course requirements and was able to work to an expanded scope of practice including increased autonomy in management and discharge of patients treated in ED and independent ordering and interpreting of plain film x-rays. The professional development package was not completed and the senior physiotherapist role was filled for only part of the study period.
Conclusions: It is feasible to implement an expanded scope of physiotherapy service in a regional hospital ED. For sustainability in regional areas, a larger advanced-level physiotherapy workforce and easier access to expanded scope training are required.