#5-66E. Streamlining the Emergency Department: The Power of Physiotherapist-Led Care (Lancet, 2026)

With emergency department crowding compromising patient safety globally, how can we optimize care for the high volume of patients presenting with musculoskeletal conditions? This landmark randomized trial (RESHAP-ED) demonstrates that a physiotherapist-led primary-contact model significantly reduces patient length of stay by one hour without compromising clinical outcomes, pain levels, or safety. Although the unblinded design and reliance on highly experienced physiotherapists may limit its generalizability to other clinical settings, the intervention proved safe and highly cost-effective. For emergency physicians, these findings provide compelling, high-quality evidence to support workforce redesign and role delegation to alleviate departmental pressure.

Citation: Sigera C, de Campos TF, Coombs DM, Williams CM, Rogan E, Edwards J, Harris IA, Naganathan V, Harvey LA, Buchbinder R, McCaffery KJ, Howard K, Haywood P, Pinheiro MB, Shan S, Billot L, Llewellyn S, Maher CG, Machado GC. Physiotherapist-led care for musculoskeletal conditions in the emergency department (RESHAP-ED): a randomised controlled trial with economic evaluation. The Lancet. 2026. DOI: 10.1016/S0140-6736(26)01327-9

URL: https://doi.org/10.1016/S0140-6736(26)01327-9

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