Peer Review Report For: Evaluation of Musculoskeletal Physiotherapy Service Quality in Ayder Comprehensive Specialized Hospital, Tigray, North Ethiopia [version 2; peer review: 1 not approved]

Abstract

Background The provision of effective musculoskeletal physiotherapy and treatment outcomes are challenged by the shortage of resources, limitations in adherence to clinical guidelines, and client unacceptability. This study aims to evaluate the process quality of musculoskeletal physiotherapy service in the physiotherapy department of Ayder Comprehensive Specialized Hospital, Mekelle, Ethiopia. Method This is a health facility-based single-embedded case study design that involves both quantitative and qualitative methods to describe the service using a three dimensions assessment for quality service evaluation (compliance of the unit, technical compliance, and service acceptability). The quantitative data was collected through document review and observation of the musculoskeletal physiotherapy unit, direct observations of 20 client-physiotherapist interactions, and chart review on systematically selected 172 client charts. For qualitative data; in-depth interviews with five Key informants and 21 clients were conducted. The interviews were audio recorded, transcribed, translated, and analyzed thematically. The data were entered into Epi-Data version 3.1 and exported to SPSS v.25 for analysis. Descriptive statistics was done and data were presented using frequency and percentage. The calculated outputs were used to judge the overall service against the predetermined criteria (i.e. Excellent, Very Good, Good, Fair, and Poor). Results The compliance of the musculoskeletal physiotherapy unit, service providers’ technical compliance, and service acceptability by the users were judged poor (56.1%), fair (60.1%), and good (73.1%) respectively. The compliance of physiotherapists in recording patient information was concerningly poor (30.2%). The majority of clients were satisfied with the service and adhered to their treatment. Conclusion & recommendation The overall service process quality of physiotherapy service was judged as fair (62.55%). However, the assessed dimensions were not as per the expected standard. Therefore, the relevant stakeholders are recommended to improve the service provision gaps.