• Simon Re Davidson, Katarzyna Bolsewicz, Steven J Kamper, Robin Haskins, Dragan Petkovic, Nicole Feenan, Damien Smith, Michael O'Flynn, Jeremy Pallas, and Christopher M Williams.
• School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia.
• Emerg Med Australas. 2022 Apr 1; 34 (2): 199-208.

ObjectiveTo identify and explore ED clinician perspectives on: (i) why patients with low back pain (LBP) present to the ED and are admitted into hospital from ED; (ii) barriers and enablers they face when providing care to patients with LBP; and (iii) strategies to improve the care of patients with LBP, and associated care processes, in the ED.MethodsWe undertook a qualitative exploratory study with ED clinicians (medical officers, nurses and physiotherapists) at a tertiary-level public hospital in New South Wales, Australia, using focus groups and individual interviews. We used thematic analysis to synthesise participant responses to answer the predefined research questions.ResultsTwenty-one clinicians participated (two individual interviews, 19 focus groups). Perceptions about better access to the ED and advanced care within ED were thought to drive presentations to the ED for LBP. Barriers and enablers to optimal patient care included patient-, clinician- and service-level factors. The main strategies to improve care included a department LBP pathway, modernised patient and clinician resources, better follow-up options post-discharge and improved communication between ED and primary care.ConclusionWe identified a range of targets to improve LBP management in ED. Clinicians perceived internal and external factors to the ED as influences of ED presentation and hospital admission. Clinicians also reported that patient-, clinician- and service-level barriers and enablers influenced patient management in ED. Strategies suggested by clinicians included improved follow-up options, access to resources and an 'LBP pathway' to support decision making.© 2021 Australasian College for Emergency Medicine.

12 keywords...

hide…