Hospital Inpatient Acute Questions

[Guest guest]

With the changes in healthcare and the reality that payment is remaining flat

(if we're lucky) or being reduced while our expenses continue to climb, we keep

saying in my facility (and I keep seeing in articles), " We can't keep treating

people the same way we did in the past, we have to think of something

different. "

To that end, in looking at hospital inpatient acute care, has anyone

implemented, or is contemplating implementing, a system whereby acute inpatients

are seen on a frequency determined solely by the PT? For example, in my

facility now we see every patient referred to us on a daily basis (post-op ortho

patients are seen BID) except on Sunday, with only very long term patients being

seen on a less frequent basis than daily.

What I'm curious to know from other hospital facilities is if you have changed

your system such that the therapist determines the frequency based upon the

patient's need, discharge status (home versus to SNF or IRF), and prognosis,

such that you may only be seeing some patients twice per week or three times per

week? If you have implemented something like that, what has been the outcome in

relation to patient progression, staffing requirements, physician relations,

Joint Commission compliance, etc.?

A more extreme question is if anyone has limited or eliminated the therapy

provided to acute inpatients who will be discharged to skilled nursing or

inpatient rehab facilities? If so, what has been the outcome of that change?

Mark Dwyer, PT, MHA

Olathe, KS

markdwyer87@...