title: The efficacy of an extended scope physiotherapy clinic in paediatric orthopaedics.
abstract: BACKGROUND
  The demand for paediatric orthopaedic care is growing, and providing the service required is an increasingly challenging task. Physiotherapist-led triage clinics are utilised in adult orthopaedics to enable the provision of care to patients who may not require a surgical consult. The Physiotherapy Orthopaedic Triage Clinic (POTC) was established in Our Lady's Children's Hospital Crumlin in response to increasing demands on the paediatric orthopaedic service. The clinic is run by physiotherapists working in an advanced practice role (APP), and is the first paediatric clinic of its type and scale in the Republic of Ireland.
  
  
  OBJECTIVE
  To evaluate the efficacy of the service over the 3-year period from January 2011 to December 2013.
  
  
  METHODS
  A review of the prospectively gathered database was performed in order to establish the demographic profile of patients, investigate clinic outcomes, and evaluate the reduction in patient waiting times.
  
  
  RESULTS
  2650 patients were managed by the clinic over the 3-year period. A total of 77 % of patients were managed without consultant intervention. Fifty-three percent of patients were diagnosed as having a normal presentation. The mean waiting time reduced from 101.9 weeks pre-2010 to 15.4 weeks in 2013 for those patients managed by the POTC.
  
  
  CONCLUSIONS
  Since its inception, the clinic has significantly reduced waiting times for routine elective paediatric orthopaedic patients while managing the majority of patients independent of surgical opinion. This study shows that the APP can deliver high-quality care in the paediatric orthopaedic setting, benefitting both patients and service.
authors.affiliation: Physiotherapy Department, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland. marieomir@gmail.com.|UCD School of Public Health, Physiotherapy and Sport Science, University College Dublin (UCD), Dublin, Ireland. marieomir@gmail.com.
authors.forename: Marie
authors.identifier: http://orcid.org/0000-0001-6458-4912
authors.initials: M
authors.lastname: O Mir
authors.affiliation: Physiotherapy Department, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland.
authors.forename: Ciara
authors.initials: C
authors.lastname: Cooney
authors.affiliation: UCD School of Public Health, Physiotherapy and Sport Science, University College Dublin (UCD), Dublin, Ireland.
authors.forename: Cliona
authors.initials: C
authors.lastname: O'Sullivan
authors.affiliation: UCD School of Public Health, Physiotherapy and Sport Science, University College Dublin (UCD), Dublin, Ireland.
authors.forename: Catherine
authors.initials: C
authors.lastname: Blake
authors.affiliation: Department of Orthopaedic Surgery, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland.
authors.forename: Paula
authors.initials: P
authors.lastname: Kelly
authors.affiliation: Department of Orthopaedic Surgery, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland.
authors.forename: Pat
authors.initials: P
authors.lastname: Kiely
authors.affiliation: Department of Orthopaedic Surgery, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland.
authors.forename: Jacques
authors.initials: J
authors.lastname: Noel
authors.affiliation: Department of Orthopaedic Surgery, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland.
authors.forename: David
authors.initials: D
authors.lastname: Moore
keywords: Advanced practice; Extended scope physiotherapy; Normal variants; Paediatric orthopaedics; Triage