Client Satisfaction With Virtual Consultations During the COVID-19 Pandemic at an Occupational Health Physical Therapy Clinic.

BACKGROUND: The purpose of this project was to determine whether clients were satisfied with their occupational health physical therapy virtual consultations and whether or not they would have preferred a face-to-face consultation instead of a virtual consultation. METHODS: Clients were mailed an adapted 10-item Telehealth Satisfaction Scale (TeSS) and asked to complete and return it in a prepaid envelope. Clients who returned the TeSS were then contacted by telephone and asked whether they would have preferred a face-to-face consultation instead of a virtual consultation. FINDINGS: Overall, clients expressed a high degree of satisfaction with their virtual occupational health physical therapy consultation (96.9%). Most clients (82.1%) stated they would have chosen virtual consultations if given the choice. CONCLUSION/APPLICATION TO PRACTICE: The cumulative feedback from clients suggested that the benefits of virtual consultations can be sustained post COVID-19 pandemic as clients have accepted and adapted to this new approach within the occupational health physical therapy clinic.

Health-Related Quality of Life and Cost-Utility Analysis of Employees With Musculoskeletal Disorders Receiving Vocational Physiotherapy.

Background: The purpose of this project was to evaluate both health-related quality of life (HRQoL) and cost-utility associated with care for employees with musculoskeletal disorders who received vocational physiotherapy at a North London National Health Service (NHS) Foundation Trust in the United Kingdom. Methods: A pre- and post-physiotherapy EuroQol 5 Dimension (EQ-5D) questionnaire was administered to employees presenting to the vocational physiotherapy service (VPS) with musculoskeletal disorders. The cost-utility analysis of the physiotherapy service was calculated using cost data provided by VPS billing information and benefits measured using Quality-Adjusted Life Years (QALYs). Findings: Overall, there was a significant improvement in the EQ-5D index from baseline to discharge in all HRQoL domains. The visual analog scale (VAS) improved from a mean of 31.5 (SD = 18.3) at baseline to 73.2 (SD = 18.5) at discharge. A cost-utility analysis indicated that the VPS would continue to be cost-effective until the cost per employee increased by 82.5%. Conclusion/Application to Practice: The project supports integration of vocational physiotherapy services into an occupational health department.

Experiences of occupational health doctors and nurses about the role of physiotherapists in occupational health rehabilitation: A qualitative study.

BACKGROUND: Occupational health physiotherapy has been practiced in the UK over several decades. In the past decade, the role of occupational health physiotherapy has gained recognition as a profession that can be embedded within occupational health departments; however, limited information is known about the role of physiotherapists from professional groups outside the allied health domain in this context. OBJECTIVE: The aim of this study is to explore the experiences of occupational health doctors and nurses about the role of physiotherapy in occupational health rehabilitation. METHODS: This study is a qualitative investigation underpinned by an interpretative construct. Thirteen semi-structured interviews were conducted. Two occupational health doctors and 12 nurses were purposively recruited from two National Health Service (NHS) hospitals. Data were analyzed using thematic content analysis, coded manually and verified by member checking. RESULTS: The benefits of occupational health physiotherapists were rapid access intervention, advanced knowledge and clinical reasoning, evidence-based practice, and providing an additional perspective. The emerging themes of the challenges that occupational health physiotherapists may face include dealing with occupational health challenges, managing role conflicts, personal qualities and attributes, and role substitution. CONCLUSION: Participants described numerous roles of occupational health physiotherapists ranging from clinical to organizational components. On-going research is needed to support the role development of physiotherapists providing occupational health rehabilitation and to further advocate for its relevance in this setting.

Calling on the Client's Perceptions About the Contributions of Physiotherapists Working in Occupational Health Services.

BACKGROUND: Clients are the recipients of occupational health care. To date, little is known about the perceptions of clients about the contribution of physiotherapists working in occupational health services. Gathering this information is imperative to understanding and responding to clients' needs. METHODS: An interpretative qualitative study was undertaken and face-to-face interviews were conducted with clients from 2 occupational health services situated within the National Health Service in the United Kingdom. Data were tape-recorded and transcribed verbatim in full. Data were analyzed using thematic analysis. RESULTS: There were 9 clients interviewed, predominantly comprising secretaries, staff nurses, and care assistants. Thematic analysis revealed 2 main themes: vocational rehabilitation and health promotion. Clients revealed distinct subcomponents of the contribution of physiotherapists in occupational health services such as functional capacity evaluations, job demand analysis, and work-specific rehabilitation. Promoting staff health was another pertinent issue reported by clients. CONCLUSIONS: Clients clearly felt that physiotherapists made a contribution to occupational health services. This information lays the groundwork for the development of physiotherapists within occupational health services, which in turn will help clients achieve better care and health outcomes.

A Critical Review of Low Back Pain Guidelines.

Low back pain (LBP) remains one of the most common and challenging musculoskeletal conditions encountered by health care professionals and is a leading cause of absenteeism. Clinical guidelines are often considered best evidence in health care. The aim of this critical review was to assess the quality and recommendations of LBP guidelines using the Appraisal of Guidelines Research and Evaluation (AGREE) instrument. Electronic databases were used to identify LBP guidelines published between 2000 and 2015. Nine guidelines were selected for review from a total of 17. Only five guidelines effectively addressed the AGREE scoring. On the basis of the appraisal and domain scores, only four guidelines were strongly recommended. Improved translation of research evidence from guidelines to clinical practice is needed.

An evaluation of the health and wellbeing needs of employees: An organizational case study.

INTRODUCTION: Workplace health and wellbeing is a major public health issue for employers. Wellbeing health initiatives are known to be cost-effective, especially when the programs are targeted and matched to the health problems of the specific population. The aim of this paper is to gather information about the health and wellbeing needs and resources of employees at one British organization. SUBJECTS AND METHODS: A cross-sectional survey was carried out to explore the health and wellbeing needs and resources of employees at one British organization. All employees were invited to participate in the survey, and, therefore, sampling was not necessary. RESULTS: 838 questionnaires were viable and included in the analysis. Employees reported "feeling happier at work" was the most important factor promoting their health and wellbeing. Physical tasks, such as "moving and handling" were reported to affect employee health and wellbeing the most. The "provision of physiotherapy" was the most useful resource at work. In all, 75% felt that maintaining a healthy lifestyle in the workplace is achievable. CONCLUSIONS: More needs to be done by organizations and occupational health to improve the working conditions and organizational culture so that employees feel that they can function at their optimal and not perceive the workplace as a contributor to ill-health.

A critical review of physiotherapy as a clinical service in occupational health departments.

Physiotherapy has been recognized as a new addition to occupational health departments. Despite the recognition and progressive implementation of physiotherapy in occupational health, evidence of role efficacy is limited. The authors critically reviewed the literature on the role and responsibilities of physiotherapists in occupational health. A comprehensive literature search was conducted. Numerous databases were electronically searched between 1990 and 2013. The literature review revealed limited evidence that physiotherapists have a role in evaluating health outcomes, conducting workplace assessments, managing musculoskeletal caseloads to reduce absenteeism, and accepting both clinical and management referrals. More research is needed to consolidate physiotherapy's role in occupational health and strengthen the evidence base.

Telephone triage assessment for musculoskeletal disorders: part 2.

This paper explores the results of a diagnostic analysis that was undertaken before the implementation of a nursing telephone triage assessment for musculoskeletal disorders in an occupational health and wellbeing service. Mixed methods were used to gather the relevant information. Authentic organisational documents provided support for several themes including evidence-based change. Several barriers and facilitators to change were identified and their implications are highlighted. Overall the organisation was classified as ready for change. Following the results of this diagnostic analysis, specific recommendations are suggested for implementation.

Telephone triage assessment for musculoskeletal disorders: part 1.

Changes in the delivery of occupational health and wellbeing services can affect the employer, employees and service users. Despite the impact of such changes, many organisations implement them without understanding their true effects. Support of staff and service users is needed if change is to be implemented and services reconfigured to improve overall efficiency. A diagnostic analysis has been recommended as a precursor to assess what impact a change would have. This paper explores the process of a diagnostic analysis before nursing telephone triage assessment for musculoskeletal disorders was implemented in an occupational health and wellbeing service. Mixed methods were used to gather the relevant information.