What’s that physical therapist doing in the ER?
Patients who are seen by a physical therapist while in the hospital typically spend fewer days there, the National Institutes of Health has concluded.
Taking it one step further and bringing physical therapy to patients while they are still in the emergency room can be even better, NIH researchers said.
Two years ago, Cape Cod Hospital tested this idea with a two-week pilot program in the Emergency Center (EC), where a physical therapist saw patients and worked with the medical staff to make decisions about their care.
The program, which is now permanent, came about after hospital administrators were looking for better ways to safely discharge patients and prevent return trips to the EC and unnecessary hospital readmissions.
“We were working on the floors and saw patients were going home and then revisiting the Emergency Center,” said Kristen Siminski, a physical therapist at Cape Cod Hospital who is part of the EC program.
A second pilot confirmed the benefits of having physical therapy in the Emergency Center. The therapists saw four to five patients a day, usually for 30 to 45 minutes at a time. Most worked between noon and 6:30 p.m., when the center is busiest.
The pilot programs gave the rehab team a chance to educate emergency center technicians, nurses, case managers and physicians about using physical therapy to help certain patients while they are in the unit.
As part of the emergency department team, the physical therapists help to care for patients with certain complaints or conditions. They diagnose and manage movement and functional disorders, and can address a wide range of acute and chronic musculoskeletal problems.
“When we’re called to evaluate, we do a head-to-toe assessment of the patient,” Siminski said. “If it looks like they’re going home, we help them decide if they need things like home care, equipment or supervision.”
Their recommendations may be as simple as suggesting the patient use a roller walker instead of a cane, or as complex as calling in a case manager to work with the patient’s family to get oversight care at home. And by providing thorough musculoskeletal exams, physical therapists can limit unnecessary scans, saving the hospital and the patient time and money.
“Doctors and case managers had some challenging discharges and they looked to us for input on how to make their transition home more successful,” said Christine Anstatt, a physical therapist who has worked in the program.
As part of the project, CCH Director of Rehabilitation Services Julie Drake and her team reached out to other facilities that had started using physical therapists in their emergency departments, to see what worked and what didn’t.
One of their findings was that educating the emergency center staff was pivotal. Once staff is onboard with the program, it goes more smoothly, Julie said.
[PHOTO: From L-R, Christine Anstatt, John Corsino, Kristen Siminski]