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Physical Therapist Determination of Discharge Disposition in the Acute Care Setting

Shoemaker, Michael J.; Gutowski, Amanda; Mallgren, Megan; Oliver, Laura; Van Dam, Ashley; McLeod, Jessica; Mohney, Emily

Journal of Acute Care Physical Therapy : July 2019 - Volume 10 - Issue 3 - p 93–106
doi: 10.1097/JAT.0000000000000099
Original Studies
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Purpose: The purpose of this retrospective chart review study was to determine whether physical therapists (PTs) were accurate in determining home discharge (DC) disposition as measured by all cause- and mobility-related readmissions and to examine the extent to which predictors of readmission are associated with PT DC disposition decision making.

Methods: A retrospective medical record review was completed for 322 patients with at least 1 PT visit who were discharged to home from a large tertiary care teaching hospital. Demographic and clinical data were collected. Multivariate binary logistic regression was used to determine predictors of readmission and PT DC recommendations for location, social support, and post–acute PT services.

Results: Only 2 of 287 (0.70%) patients recommended for home DC by PT were readmitted and 4 of the 287 (1.39%) returned to the emergency department for mobility-related problems. Having 24-hour social support available upon DC was the only significant predictor of all 3 PT DC recommendations; otherwise, no extensive overlap of predictors was found among the regression models.

Conclusions: The results of the present study affirm the accuracy of PT determination of safe DC to home, and although no extensive overlap of the predictors of readmission and PT decision making was found, the relationships among the various predictors are hypothesis-generating as to the way in which PT decision making might help reduce non–mobility-related readmissions.

Michael J. Shoemaker, PT, DPT, PhD, GCS Department of Physical Therapy, Grand Valley State University, 301 Michigan St NE, Grand Rapids, MI 49503 (USA). shoemami@gvsu.edu.

Department of Rehabilitation Services, Spectrum Health, Grand Rapids, Michigan.

Amanda Gutowski, PT, DPT Department of Physical Therapy, Grand Valley State University, Grand Rapids, Michigan.

Megan Mallgren, PT, DPT Department of Physical Therapy, Grand Valley State University, Grand Rapids, Michigan.

Laura Oliver, PT, DPT Department of Physical Therapy, Grand Valley State University, Grand Rapids, Michigan.

Ashley Van Dam, PT, DPT Department of Rehabilitation Services, Spectrum Health, Grand Rapids, Michigan.

Jessica McLeod, PT, DPT Department of Rehabilitation Services, Spectrum Health, Grand Rapids, Michigan.

Emily Mohney, PT, DPT Department of Rehabilitation Services, Spectrum Health, Grand Rapids, Michigan.

The authors have no conflicts of interest and no source of funding to declare.

© 2019 by Lippincott Williams & Wilkins, Inc.
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