Consumer preferences regarding physiotherapy practitioners and nurse practitioners in emergency departments – a qualitative investigation

ABSTRACT

Workforce reform has led to Nurse Practitioners (NP) and Physiotherapy Practitioners (PP) employed in Emergency Departments (ED) to see patients alongside doctors. This qualitative study gathered consumer opinions and preferences regarding NPs, PPs, and doctors, and the attributes desired of them. Twenty-two members of the organization’s Consumer Representative Program participated in one of three focus groups which were audio-recorded and transcribed verbatim. Data were subsequently collected using an emergent-systematic design that enabled ideas to be explored and refined in sequential focus groups. Data analysis, utilizing the principles of thematic analysis, identified four themes. First, consumers understand and accept that reform is necessary to improve care, better utilize available resources and create sustainable services. Second, although consumers accept the rationale for employing NPs and PPs, preferences vary regarding who they want as their primary clinician. Some consumers do not mind who provides care as long as they receive the care they need; others believe doctors provide superior care and preferred a doctor; a third group indicated that not everyone who presents to an ED needs to see a doctor and specialized care would be provided by NPs and PPs for certain conditions. Some consumers expressed incomplete or inaccurate understanding of ED staff roles, responsibilities, and skillsets, which influenced their care preferences. Third, consumers identified a core set of desirable staff attributes that apply to everyone irrespective of professional demarcation; all staff should embody these attributes, though the expression of the attributes will vary according to circumstances and the staff member’s scope of practice. Fourth, consumers expect effective governance over ED services so that all staff, irrespective of their profession provides safe and effective care. In conclusion, these results can be used by health-care administrators and clinicians to inform workforce reform in EDs, helping to ensure that consumers’ opinions and preferences are acknowledged and appropriately addressed.

KEYWORDS:

• Healthcare reform
• interprofessional practice
• emergency department
• physiotherapist
• nurse practitioner
• professional boundaries

Acknowledgments

The authors remain grateful for the generous contributions made by the consumer representatives. Michelle Courtney and Jessica Connor Kennedy from Barwon Health’s Consumer Engagement Team enabled the consumer representatives’ participation. Nurse Practitioners Darren Smith, Libby Ellis, Michael Hardie, and Rory Jamieson reviewed the manuscript for intellectual rigor and to ensure their role within the ED was accurately represented. Physiotherapists Chris Lindner, Fiona Brennan, and Peter Schoch also critically reviewed the manuscript.

Disclosure Statement

No potential conflict of interest was reported by the author.

Additional information

Funding

The study was completed within the authors’ current roles and no additional funding was received.