Development of a unique triage system for acute care physical therapy and occupational therapy services: an administrative case report.

Background and Purpose. This administrative case report documents the development of a mechanism by which systematic triage was used to assign patients to therapists in acute care settings. The primary objective was to develop a triage tool to improve patient access to medically necessary therapy se...

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Publicado en:Physical Therapy Vol. 90; no. 10; pp. 1519 - 1530
Autores principales: Hobbs JA, Boysen JF, McGarry KA, Thompson JM, Nordrum JT
Formato: algorithm equations & formulas research tables/charts Journal Article
Publicado: Oxford University Press / USA Oct2010
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct2010
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      pub: Oxford University Press / USA
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        atl: Development of a unique triage system for acute care physical therapy and occupational therapy services: an administrative case report.
      aug:
        au:
          Hobbs JA
          Boysen JF
          McGarry KA
          Thompson JM
          Nordrum JT
        affil: Director of Therapy Services, Department of Physical Medicine and Rehabilitation, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (USA)
      sug:
        subj:
          Triage Methods
          Physical Therapy
          Occupational Therapy
          Acute Care
          Decision Trees
          Referral and Consultation
          Human
          Validation Studies
          Chi Square Test
          Descriptive Statistics
          Acute Disease Rehabilitation
          Workload
          Data Analysis Software
          P-Value
      ab: Background and Purpose. This administrative case report documents the development of a mechanism by which systematic triage was used to assign patients to therapists in acute care settings. The primary objective was to develop a triage tool to improve patient access to medically necessary therapy services. Case Description. A unique triage tool and a decision tree were developed to determine which patients referred to therapists for acute care therapy required skilled services. The triage tool was used to examine therapy referrals for patients from 2 large academic hospitals; 6 criteria were used to determine which evaluations should be cancelled. During the trial period, the predictive ability of individual triage criterion items was analyzed, the tool was modified and validated, and a decision tree was established. Descriptive and chi-square analyses were performed on all variables of interest. Outcomes. The systematic triage system reduced the number of therapy evaluations that were not appropriate by 29%, resulting in an improvement in the availability of therapy services for patients who required skilled care. The average number of patients per therapist per workday decreased from 18.9 to 12.1 and from 15.1 to 12.8 in the 2 hospitals. An improvement in a newly developed "workload index" related to missed patient visits also indicated the success of this project. Discussion. A novel systematic triage system reduced the number of therapy evaluations that were not appropriate, resulting in an improvement in the availability of therapy services for patients who require skilled intervention.
      pubtype: Academic Journal
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        algorithm
        equations & formulas
        research
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        Journal Article
      ougenre: Article
    language: English
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