Mrs Laura Restoux1, Mr David Verhagen1, Ms Alexandra Ooi1, Dr Simon McCaffrey1, Ms Deborah Wilson1
1Central Coast Local Health District, Central Coast, Gosford, Australia
To compare the pathway, clinical outcomes and satisfaction of women accessing a traditional Gynaecology Model of Care (MOC) to an Advanced Practice Physiotherapy (APP) MOC.
Retrospective audit and pilot study. CCLHD Research Ethics Committee (0221-015C).
A 6 month retrospective audit of the traditional MOC was conducted. Administrative and Gynaecology triage processes were redeveloped to establish an APP pathway. Physiotherapists underwent APP competency training with Gynaecologists. After 6 months of implementation of this APP MOC another retrospective audit will be completed. Descriptive statistics will be utilised to compare the two MOC.
Within a 6-month period 317 patients triaged as Category 3 referrals with pelvic floor conditions were identified accessing the traditional MOC. Patients were waiting on average 164.27 days from referral until first contact with their Gynaecologist. Treatment provided was not in line with International Clinical Guidelines (Dumoulin et al., 2017) as conservative treatment was not always provided prior to medical and surgical management. Utilising an eligibility criterion from a Victorian APP MOC 73.4% of these patients (233 women) were deemed appropriate to have been seen by an APP. Instead, treatment was delayed by waiting to be seen by a Gynaecologist first. Implementing an APP MOC maybe a viable option to reduce wait times for these women.
An APP MOC within NSW Health appears feasible and more cost effective, and may reduce gynaecology waitlists. More importantly care pathways are streamlined, management is evidence-based and it is anticipated that patients will have better clinical outcomes and QOL.
Key Practice Points
- Traditional Gynaecology MOC for patients presenting with pelvic floor conditions is inefficient and is not evidence based
- These findings highlight the importance of exploring new MOC within NSW Health to address these issues in the interests of better value care for our patients
Laura Restoux practices as a Senior Physiotherapist with the Central Coast Local Health District and has worked in Women’s, Men’s & Pelvic Health in both the public and private sectors. She has previously worked at the Royal Hospital for Women in Sydney. She has been the NSW chair of the Australian Physiotherapy Association’s Women’s, Men’s & Pelvic Health Committee for the last 4 years. Laura has completed her Master’s degree at Curtin University, majoring in Continence and Women’s Health. She has also completed a Graduate Certificate in Continence Promotion and Management as a scholarship offered by the Continence Foundation of Australia and the Benchmarque Group. Laura has previously published research on the Impact of Inflammatory Arthritis on Sexual Function and Intimate Relationships.