Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora.
Denver Veterans Affairs Medical Center, Denver, Colorado.
J Geriatr Phys Ther. 2019 Jul/Sep;42(3):E73-E80. doi: 10.1519/JPT.0000000000000187.
Recent evidence has suggested physical therapist involvement in care transitions after hospitalization is associated with reduced rates of hospital readmissions. However, little is known about how physical therapists participate in care transitions for older adults, the content of care communications, and the facilitators and barriers of implementing evidence-based care transition strategies into practice. Thus, the purpose of this article is to evaluate participation in care transition activities known to influence readmission risk among older adults, and understand perceptions of and barriers to participation in these activities.
We developed a survey questionnaire to quantify hospital-based physical therapist participation in care transitions and validated it using cognitive interviewing. It was introduced to a cross-sectional national sample of physical therapists who participate in the Academy of Acute Care Physical Therapy electronic discussion board using a SurveyMonkey tool.
More than 90% of respondents agreed they routinely recommended a discharge location and provided recommendations for durable medical equipment for patients at the time of hospital discharge. Respondents did not routinely initiate communication with therapists in other care settings, or follow up with patients to determine whether recommendations were followed. A majority of respondents agreed their facilities would not consider many key care transition activities to count as productive time.This survey provides a novel insight into how hospital-based physical therapists participate in care transitions. Communications between rehabilitation providers across care settings are infrequent, even though those communications are recommended to help reduce readmissions. However, administrative barriers were elucidated in this study that may help explain lack of therapist involvement.
Physical therapists' communications across health care setting about older adults discharging from acute care hospitalization are infrequent, but may represent a meaningful intervention target for future studies. Future research is needed to evaluate best practices for hospital-based physical therapists during care transitions.
最近的证据表明，物理治疗师参与住院后的护理交接与降低医院再入院率有关。然而，人们对物理治疗师如何参与老年人的护理交接、护理沟通的内容以及将基于证据的护理交接策略实施到实践中的促进因素和障碍知之甚少。因此，本文的目的是评估已知会影响老年人再入院风险的护理交接活动的参与情况，并了解对参与这些活动的看法和障碍。
我们开发了一个调查问卷调查表，以量化医院内物理治疗师参与护理交接的情况，并通过认知访谈对其进行验证。它被介绍给了一个跨学科的全国性物理治疗师样本，他们在 Academy of Acute Care Physical Therapy 的电子讨论板上使用 SurveyMonkey 工具参与。
超过 90%的受访者同意，他们在患者出院时通常会推荐出院地点，并为耐用医疗设备提供建议。受访者通常不会主动与其他护理环境中的治疗师进行沟通，也不会跟进患者以确定是否遵循了建议。大多数受访者同意，他们的医疗机构不会认为许多关键的护理交接活动是有成效的。这项调查提供了一个新颖的视角，了解医院内的物理治疗师如何参与护理交接。康复提供者之间在护理环境中的沟通很少，尽管这些沟通被推荐以帮助减少再入院。然而，本研究揭示了行政障碍，这可能有助于解释治疗师参与不足的原因。
关于从急性护理住院出院的老年人，康复提供者之间在医疗保健环境中的交流很少，但这可能是未来研究的一个有意义的干预目标。需要进一步研究来评估医院内物理治疗师在护理交接期间的最佳实践。
