Impact of Using Physiotherapy Self-Referral in the Medical–Surgical Neurological Intensive Care Unit

Abstract

Purpose: To describe physiotherapy (PT) referral practice in a medical–surgical neurological intensive care unit (MSNICU) of a large quaternary teaching hospital before and after the implementation of PT self-referral. Methods: Charts were reviewed for MSNICU patients who received PT pre-implementation (Pre; n=90) and post-implementation (Post; n=100) to collect data on timeliness, number of referrals, and MSNICU length of stay (LOS); t-tests were conducted to determine group differences. Results: The mean age of MSNICU patients referred to PT was 60.6 (SD=18.6) years; 59.5% were male. PT treatment consisted of cardiorespiratory (39% Pre, 51.1% Post), mobility (22% Pre, 28.8% Post), and combined (39% Pre, 20% Post) interventions. Overall, the number of days between MSNICU admission and PT initiation and MSNICU LOS did not differ significantly from Pre to Post. However, for patients (n=50) receiving early (within 7 days of MSNICU admission) PT self-referral Post versus patients receiving physician referral only Pre (n=83), there was a significant decrease (p=0.01) in time to PT initiation of 1.4 days (3.2 Pre, 1.8 Post). Conclusions: PT self-referral increased both the number of patients receiving more timely access to PT and the provision of treatment of a deferred group of patients previously not referred. Future studies need to evaluate the impact of referral methods across a variety of clinical populations.