What is the role of a physical therapist (PT) in discharge planning?

The Role of Physical Therapists in Discharge Planning

Physical therapists play a critical role in discharge planning by conducting functional assessments, determining appropriate post-discharge care settings, and developing comprehensive rehabilitation plans to optimize patient outcomes and reduce readmission risks.

Core Responsibilities of Physical Therapists in Discharge Planning

• Conduct comprehensive functional assessments to determine patients' mobility status, safety concerns, and rehabilitation needs prior to discharge 1, 2
• Participate in regular interprofessional team meetings to discuss patient progress, rehabilitation goals, and discharge needs 1, 2
• Perform pre-discharge home assessments to evaluate the home environment for safety, accessibility, and necessary modifications 1, 2
• Develop individualized home exercise programs and activity modifications to support continued recovery after discharge 2, 3
• Provide caregiver training on proper positioning, handling, transfers, and techniques to promote patient independence 1, 2
• Make evidence-based recommendations for appropriate discharge destinations and follow-up services 4, 3
• Create written discharge instructions addressing functional ability, safety considerations, and action plans for continued recovery 2, 5
• Establish clear communication channels with next providers of care to ensure continuity of rehabilitation services 2, 6

Impact of Physical Therapist Recommendations on Patient Outcomes

• Physical therapists' discharge recommendations are implemented approximately 83% of the time, demonstrating their accuracy and value in the discharge planning process 3
• Patients are 2.9 times more likely to be readmitted when physical therapist discharge recommendations are not implemented and recommended follow-up services are lacking 3
• Early and appropriate physical therapy involvement in discharge planning has been shown to improve functional outcomes and increase cost-effectiveness compared to other discharge options 1

Best Practices for Physical Therapists in Discharge Planning

• Begin discharge planning as early as possible after admission, not waiting until late in the patient's stay 2, 5
• Use standardized assessment tools to objectively document functional status and mobility needs 1, 5
• Identify potential barriers to discharge early in the process to prevent delays 2, 5
• Involve patients and caregivers in rehabilitation sessions to prepare them for post-discharge care 1, 2
• Develop goal-oriented discharge plans with specific target dates 2, 6
• Ensure comprehensive documentation of clinical handover information to subsequent care providers 5, 3
• Schedule follow-up appointments prior to discharge to ensure continuity of care 2, 6

Specialized Equipment Assessment and Recommendations

• Evaluate and recommend appropriate assistive devices, adaptive equipment, and mobility aids needed for safe discharge 1, 7
• Consider patient diagnosis, prognosis, functional status, mental status, environment, and funding when making wheelchair or equipment recommendations 7
• Ensure patients and caregivers receive proper training on the use and maintenance of all recommended equipment 2, 7

Common Pitfalls to Avoid

• Delaying the initiation of discharge planning until late in the patient's stay 2
• Failing to identify potential barriers to discharge early in the process 2, 5
• Inadequate communication between healthcare team members during transitions of care 6, 5
• Insufficient patient and caregiver education regarding home exercise programs and activity modifications 2, 5
• Not providing comprehensive written discharge instructions 2, 5
• Overlooking the assessment of caregiver capacity and patient/family psychosocial needs that may impact recovery 2, 3

Evolution of Physical Therapist Discharge Decision-Making

• With experience, physical therapists place greater emphasis on the patient's role in their rehabilitation and increasingly promote self-management goals 8
• Experienced physical therapists develop more sophisticated approaches to negotiating goals with patients and conceptualizing their roles in discharge decisions 8
• Decision-making regarding discharge recommendations is guided by consideration of patients' functioning and disability, wants and needs, ability to participate in care, and life context 4