Article

Acute care physical therapists contribute to the complex process of
patient discharge planning. As physical therapists are experts at evaluating
functional abilities and are able to incorporate various other factors relevant
to discharge planning, it was expected that physical therapists' recommendations
of patient discharge location would be both accurate and appropriate. OBJECTIVE:
This study determined how often the therapists' recommendations for patient
discharge location and services were implemented, representing the accuracy of
the recommendations. The impact of unimplemented recommendations on readmission
rate was examined, reflecting the appropriateness of the recommendations. DESIGN:
This retrospective study included the discharge recommendations of 40 acute care
physical therapists for 762 patients in a large academic medical center. The
frequency of mismatch between the physical therapist's recommendation and the
patient's actual discharge location and services was calculated. The mismatch
variable had 3 levels: match, mismatch with services lacking, or mismatch with
different services. Regression analysis was used to test whether mismatch status,
patient age, length of admission, or discharge location predicted patient
readmittance. RESULTS: Overall, physical therapists' discharge recommendations
were implemented 83% of the time. Patients were 2.9 times more likely to be
readmitted when the therapist's discharge recommendation was not implemented and
recommended follow-up services were lacking (mismatch with services lacking)
compared with patients with a match. Limitations This study was limited to one
facility. Limited information about the patients was collected, and data on
patient readmission to other facilities were not collected. CONCLUSIONS: This
study supports the role of physical therapists in discharge planning in the acute
care setting. Physical therapists demonstrated the ability to make accurate and
appropriate discharge recommendations for patients who are acutely ill.

Langue : ANGLAIS