Physical therapy consultation in the emergency department for older adults with falls: A qualitative study
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 consultat...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-04-01
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| Series: | Journal of the American College of Emergency Physicians Open |
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| Online Access: | https://doi.org/10.1002/emp2.12941 |
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| author | Anita Chary Elise Brickhouse Beatrice Torres Lauren Cameron‐Comasco Sangil Lee Brittany Punches Rachel M. Skains Aanand D. Naik Catherine C. Quatman‐Yates Maura Kennedy Lauren T. Southerland Shan Liu |
| author_facet | Anita Chary Elise Brickhouse Beatrice Torres Lauren Cameron‐Comasco Sangil Lee Brittany Punches Rachel M. Skains Aanand D. Naik Catherine C. Quatman‐Yates Maura Kennedy Lauren T. Southerland Shan Liu |
| author_sort | Anita Chary |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-007046624f53410c85e3bfbcf52e48b7 |
| institution | OA Journals |
| issn | 2688-1152 |
| language | English |
| publishDate | 2023-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the American College of Emergency Physicians Open |
| spelling | doaj-art-007046624f53410c85e3bfbcf52e48b72025-08-20T01:55:45ZengElsevierJournal of the American College of Emergency Physicians Open2688-11522023-04-0142n/an/a10.1002/emp2.12941Physical therapy consultation in the emergency department for older adults with falls: A qualitative studyAnita Chary0Elise Brickhouse1Beatrice Torres2Lauren Cameron‐Comasco3Sangil Lee4Brittany Punches5Rachel M. Skains6Aanand D. Naik7Catherine C. Quatman‐Yates8Maura Kennedy9Lauren T. Southerland10Shan Liu11Department of Emergency Medicine Baylor College of Medicine Houston Texas USASchool of Medicine Baylor College of Medicine Houston Texas USAUT Health Science Center University of Texas School of Public Health Houston Texas USABeaumont Hospital Royal Oak Michigan USACollege of Medicine University of Iowa Carver Iowa City Iowa USADepartment of Emergency Medicine The Ohio State University Columbus Ohio USADepartment of Emergency Medicine University of Alabama at Birmingham Birmingham Alabama USACenter for Innovations in Quality, Effectiveness and Safety Michael E. DeBakey VA Medical Center Houston Texas USASchool of Health and Rehabilitation Sciences The Ohio State University Columbus Ohio USADepartment of Emergency Medicine Massachusetts General Hospital Boston Massachusetts USADepartment of Emergency Medicine The Ohio State University Columbus Ohio USADepartment of Emergency Medicine Massachusetts General Hospital Boston Massachusetts USAAbstract 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.https://doi.org/10.1002/emp2.12941fallsgeriatricsinjuryobservationolder adultsphysical therapy |
| spellingShingle | Anita Chary Elise Brickhouse Beatrice Torres Lauren Cameron‐Comasco Sangil Lee Brittany Punches Rachel M. Skains Aanand D. Naik Catherine C. Quatman‐Yates Maura Kennedy Lauren T. Southerland Shan Liu Physical therapy consultation in the emergency department for older adults with falls: A qualitative study Journal of the American College of Emergency Physicians Open falls geriatrics injury observation older adults physical therapy |
| title | Physical therapy consultation in the emergency department for older adults with falls: A qualitative study |
| title_full | Physical therapy consultation in the emergency department for older adults with falls: A qualitative study |
| title_fullStr | Physical therapy consultation in the emergency department for older adults with falls: A qualitative study |
| title_full_unstemmed | Physical therapy consultation in the emergency department for older adults with falls: A qualitative study |
| title_short | Physical therapy consultation in the emergency department for older adults with falls: A qualitative study |
| title_sort | physical therapy consultation in the emergency department for older adults with falls a qualitative study |
| topic | falls geriatrics injury observation older adults physical therapy |
| url | https://doi.org/10.1002/emp2.12941 |
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