Journal article
Physical therapy consultation in the emergency department for older adults with falls: A qualitative study
Journal of the American College of Emergency Physicians Open, Vol.4(2), e12941
04/2023
DOI: 10.1002/emp2.12941
PMCID: PMC10114865
PMID: 37090953
Abstract
Objectives
Little is known about current practices in consulting physical therapy (PT) in the emergency department (ED) for older adults with falls, a practice that can reduce fall‐related ED revisits. This qualitative study aimed to understand perspectives of ED staff about ED PT consultation for older adults with falls and fall‐related complaints, specifically regarding perceived value and associated challenges and strategies.
Methods
We performed focus groups and key informant interviews with emergency physicians, advanced practice clinicians, nurses, physical therapists, occupational therapists, and technicians who perform ED geriatric screenings. We used rapid qualitative analysis to identify common themes related to decisions to consult PT from the ED, perceived value of PT, and common challenges and strategies in ED PT consultation.
Results
Twenty‐five participants in 4 focus groups and 3 interviews represented 22 distinct institutions with ED PT consultation available for older adults with falls. About two thirds of EDs represented relied on clinician gestalt to request PT consultation (n = 15, 68%), whereas one third used formal consultation pathways (n = 7, 32%). Participants valued physical therapists’ expertise, time, and facilitation of hospital throughput by developing safe discharge plans and contact with patients to improve outpatient follow‐up. Common challenges included limited ED PT staffing and space for PT evaluations; strategies to promote ED PT consultation included advocating for leadership buy‐in and using ED observation units to monitor patients and avoid admission until PT consultation was available.
Conclusion
ED PT consultation for older adults with falls may benefit patients, ED staff, and hospital throughput. Uncertainty remains over whether geriatric screening‐triggered consultation versus emergency clinician gestalt successfully identifies patients likeliest to benefit from ED PT evaluation. Leadership buy‐in, designated consultation space, and formalized consultation pathways are strategies to address current challenges in ED PT consultation.
Details
- Title: Subtitle
- Physical therapy consultation in the emergency department for older adults with falls: A qualitative study
- Creators
- Anita Chary - Baylor College of MedicineElise Brickhouse - Baylor College of MedicineBeatrice Torres - The University of Texas Health Science Center at HoustonLauren Cameron-Comasco - Oakland UniversitySangil Lee - University of IowaBrittany Punches - The Ohio State UniversityRachel M. Skains - University of Alabama at BirminghamAanand D. Naik - Michael E. DeBakey VA Medical CenterCatherine C. Quatman-Yates - The Ohio State UniversityMaura Kennedy - Massachusetts General HospitalLauren T. Southerland - The Ohio State UniversityShan Liu - Massachusetts General Hospital
- Resource Type
- Journal article
- Publication Details
- Journal of the American College of Emergency Physicians Open, Vol.4(2), e12941
- DOI
- 10.1002/emp2.12941
- PMID
- 37090953
- PMCID
- PMC10114865
- NLM abbreviation
- J Am Coll Emerg Physicians Open
- ISSN
- 2688-1152
- eISSN
- 2688-1152
- Number of pages
- 10
- Language
- English
- Date published
- 04/2023
- Academic Unit
- Emergency Medicine; Injury Prevention Research Center
- Record Identifier
- 9984398345202771
Metrics
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