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Titre : | Omission of Physical Therapy Recommendations for High-Risk Patients Transitioning From the Hospital to Subacute Care Facilities (2015) |
Auteurs : | Brock Polnaszek ; Jacquelyn Mirr ; Rachel Roiland |
Type de document : | Article |
Dans : | Archives of Physical Medicine and Rehabilitation (2015/11, 2015) |
Article en page(s) : | pp. 19661972 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Communication ; Kinésithérapie (spécialité) ; Prestations des soins de santé ; Réadmission du patient ; Rééducation et réadaptation ; Sécurité des patients ; Soins de suite ; Sortie du patient |
Mots-clés: | Delivery of health care ; Patient discharge ; Patient discharge summaries ; Comptes-rendus de sortie des patients ; Patient readmission ; Patient safety ; Physical therapy specialty ; Physicians ; Médecins ; Subacute care |
Résumé : |
Objectives To assess the quality and explore the potential impact of the communication of physical therapy (PT) recommendations in hospital discharge summaries/orders for high-risk subacute care populations, specifically targeting recommendations for (1) maintenance of patient safety, (2) assistance required for mobility, and (3) use of assistive devices. Design Medical record abstraction of retrospective cohort comparing discharge recommendations made by inpatient PT to orders included in written hospital discharge summaries/orders, the primary form of hospital-to-subacute care communication. Data were linked to Medicare outcomes from corresponding years for all Medicare beneficiaries in the cohort. Setting Academic hospital. Participants All hospitalized patients (N=613 overall) 18 years and older with primary diagnoses of stroke or hip fracture, with an inpatient PT consultation and discharged to subacute care during the years 2006 to 2008; 366 of these were Medicare beneficiaries. Interventions Not applicable. Main Outcome Measures Combined rehospitalization, emergency department visit, and/or death within 30 days of discharge. Results Omission of recommendations for maintaining patient safety occurred in 54% (316/584) of patients; for assistance required for mobility, in approximately 100% (535/537); and for use of assistive devices, in 77% (409/532). As compared with those without patient safety restriction/precaution omissions, Medicare beneficiaries with such omissions demonstrated a trend toward more negative 30-day outcomes (26% vs 18%, P=.10). Similar, albeit nonsignificant, outcome trends were observed in the other omission categories. Conclusions PT recommendations made during a hospital stay in high-risk patients are routinely omitted from hospital discharge communications to subacute care facilities. Interventions to reliably improve this communication are needed. |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S0003999315006218 |