• Kirsten Strudwick, Romany Martin, Fiona Coombes, Anthony Bell, Melinda Martin-Khan, and Trevor Russell.
• Emergency and Physiotherapy Departments, QEII Jubilee Hospital, Metro South Health, Brisbane, Queensland, Australia.
• Emerg Med Australas. 2022 Apr 1; 34 (2): 209-222.

ObjectiveTo investigate the quality of care provided by EDs with physiotherapy services compared to those without, using established musculoskeletal process and outcome quality indicators (QIs).MethodsAn analysis was undertaken of prospective observational and chart audit data collected from 628 patients who presented with a musculoskeletal injury in any of the eight participating EDs in Queensland in 2016-2017. The care provided was scored against 46 musculoskeletal QIs. Quality of care was first compared between EDs with physiotherapists to EDs with a limited physiotherapy service, and second between EDs with primary contact physiotherapists to EDs without. χ2 and Fisher's exact tests were used to identify significant results.ResultsIn the first comparison, EDs with physiotherapists performed significantly higher on 15 QIs and EDs with only limited physiotherapy performed higher on two QIs. In the second comparison, EDs with primary contact physiotherapists performed significantly higher on 17 QIs when compared to EDs without and three QIs demonstrated significance in favour of EDs without primary contact physiotherapists. Performance differences occurred across both process and outcome QIs, including musculoskeletal assessment, diagnostics, pain assessment and management, fracture management, medication safety, mobility, patient information, referrals and follow-up, re-presentations and patient experience.ConclusionsEDs with physiotherapists provide at least equivalent or higher quality of care for patients with musculoskeletal injuries than those EDs with limited access to physiotherapists. This may be because of their specialised training in musculoskeletal diagnosis and treatment, as well as the impact of teaching and mentoring for other ED clinicians.© 2021 Australasian College for Emergency Medicine.

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