Perceptions regarding the relevance of integrating an advanced practice physiotherapist into emergency department settings in Belgium: a qualitative exploratory study.

backgroundBelgium’s emergency services face several public health challenges, including increasing patient numbers and a shortage of medical staff. Against this backdrop, there is a risk that current organisational structures may not provide optimal responses to growing care demands. Countries facing similar challenges have adopted innovative care models that integrate advanced practice physiotherapists (APPs) into emergency teams. Belgium could draw inspiration from these successful models to improve its healthcare system. This exploratory study aims to assess the relevance of integrating APPs into emergency departments in French-speaking Belgium.

methodsThis study employed a descriptive qualitative approach following an iterative process: (1) focus groups to define the needs, roles and skills of APPs with 19 physicians and nurses from three Belgian emergency departments; (2) construction of care pathways integrating APPs for each hospital; and (3) elaboration of the final framework via NVivo software. The results are based on consensus among participants across all participating hospitals.

resultsThe participants supported the integration of APPs into their emergency departments, believing this would improve care quality, optimise the use of available care resources, and enhance patient care pathway organisation. The two main care pathways incorporating APPs described were as follows: first-contact, autonomous management of patients with musculoskeletal disorders, and intervention as an expert in the multidisciplinary management of patients requiring respiratory care. The CanMEDS roles assigned to APPs include clinical expert, communicator, collaborator, leader, health promoter and scholar. The medical tasks and skills required to fulfil these roles include performing diagnostic and therapeutic procedures, providing autonomous guidance and coordinating patient care.

conclusionThis study suggests the potential benefits of integrating APPs into several Belgian emergency departments. The results align with models used in other countries reporting APPs’ ability to optimise emergency care through the management of non-critical patients. This study provides a theoretical basis for future research aimed at clarifying APPs’ tasks, roles and skills, and evaluating the implementation of these new care models.