700 Section - Physiatry-physiotherapy interdisciplinary project (PHY2) : evaluation of a new caregiving model for musculoskeletal pain by advanced practice physiotherapists in a physiatry department

Access to physical medicine and rehabilitation (PM&R) specialists in Canada, especially for musculoskeletal (MSK) care, is limited by physician shortages. Integrating advanced practice physiotherapists (APPs) into MSK teams has improved wait times, satisfaction, and care quality in various clinical  settings internationally. This study aims to highlight the benefits of a collaborative care model combining APPs and physiatrists, addressing a gap in the existing literature.


Design:

300 patients referred from specialists working at Centre Hospitalier de l’Université de Montreal (CHUM) were recruited from the physiatry referral pool between January 2023 and October 2023 to be initially evaluated by an APP of our team. The care trajectories were followed to identify a potential improvement in efficiency in the physiatry department with the integration of APPs. Descriptive statistics and confidence intervals (CIs) were calculated for patient demographic and clinical variables. Chi-Square or Fisher's exact tests were used to compare categorical variables between the groups.


Results:

41.3% (n=124/300) of the participants were discharged by the APP without the need for a physiatry consultation. The rate of direct discharge by the APP was as high as 24%. The APP team saw a total of 454 new patients in the study’s duration, representing approximately 12 % of all new referrals to the physiatry department coming from CHUM specialists. The mean waiting time were significantly shorter than the waiting time to see a physiatrist. The mean satisfaction score after initial APP assessment was 9.72 on a scale of 1 to 10 (n= 278).


Conclusion: Implementing a multidisciplinary collaborative model with an APP can lead to a gain of efficiency with better patient selection evaluated by physiatrists