Physical Therapy and Orthopaedic Surgery, Program in Physical Therapy, Washington University School of Medicine, Campus Box 8502, 4444 Forest Park Blvd, Suite 1101, St Louis, MO 63108, USA.
Phys Ther. 2010 Mar;90(3):420-6. doi: 10.2522/ptj.20080268. Epub 2010 Jan 7.
The American Physical Therapy Association's Vision 2020 advocates that physical therapists be integral members of health care teams responsible for diagnosing and managing movement and functional disorders. This report details the design and early implementation of a physical therapist service in the emergency department (ED) of a large, urban hospital and presents recommendations for assessing the effectiveness of physical therapists in this setting.
Emergency departments serve multiple purposes in the American health care system, including care of patients with non-life-threatening illnesses. Physical therapists have expertise in screening for problems that are not amenable to physical therapy and in addressing a wide range of acute and chronic musculoskeletal pain problems. This expertise invites inclusion into the culture of ED practice. This administrative case report describes planning and early implementation of a physical therapist practice in an ED, shares preliminary outcomes, and provides suggestions for expansion and effectiveness testing of practice in this novel venue.
Referrals have increased and length of stay has decreased for patients receiving physical therapy. Preliminary surveys suggest high patient and practitioner satisfaction with physical therapy services. Outpatient physical therapy follow-up options were developed. Educating ED personnel to triage patients who show deficits in pain and functional mobility to physical therapy has challenged the usual culture of ED processes.
Practice in the hospital ED enables physical therapists to fully use their knowledge, diagnostic skills, and ability to manage acute pain and musculoskeletal injury. Recommendations for future action are made to encourage more institutions across the country to incorporate physical therapy in EDs to enhance the process and outcome of nonemergent care.
美国物理治疗协会的 2020 愿景主张物理治疗师成为医疗团队的重要成员，负责诊断和管理运动和功能障碍。本报告详细介绍了在一家大型城市医院的急诊科设立物理治疗师服务的设计和早期实施情况，并提出了评估物理治疗师在这种环境下效果的建议。
急诊科在美国的医疗体系中具有多种功能，包括治疗非危及生命疾病的患者。物理治疗师在筛查无法接受物理治疗的问题以及处理各种急性和慢性肌肉骨骼疼痛问题方面具有专业知识。这种专业知识使得他们能够被纳入急诊科的实践文化中。本行政案例报告描述了在急诊科设立物理治疗师实践的规划和早期实施情况，分享了初步结果，并为在这一新场所扩展和测试实践效果提供了建议。
接受物理治疗的患者的转诊量增加，住院时间缩短。初步调查显示，患者和从业者对物理治疗服务的满意度很高。开发了门诊物理治疗的后续选择。教育急诊科工作人员对表现出疼痛和功能移动障碍缺陷的患者进行分诊，以接受物理治疗，这对急诊科通常的流程文化提出了挑战。
在医院急诊科的实践使物理治疗师能够充分利用他们的知识、诊断技能和管理急性疼痛和肌肉骨骼损伤的能力。提出了未来行动的建议，以鼓励全国更多的机构在急诊科纳入物理治疗，从而改善非紧急护理的流程和结果。
