Physical Therapists Make Accurate and Appropriate Discharge Recommendations for Patients Who Are Acutely Ill

Abstract

BackgroundAcute 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.ObjectiveThis 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.DesignThis 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.ResultsOverall, 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.LimitationsThis study was limited to one facility. Limited information about the patients was collected, and data on patient readmission to other facilities were not collected.ConclusionsThis 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.