Collaborative Care Across the Acute and Subacute Continuum Facilitated by Physical Therapy in the Emergency Department

Abstract

Background: Research has supported the use of physical therapy services within emergency departments (EDs) in relation to fall reduction, reduced readmissions, and positive patient satisfaction. While the evidence supports the use of physical therapy services in the ED, other authors fail to provide examples of what collaboration looks like at the personal, professional, and patient levels. This case report is unique in that it describes the effects of collaborative care across the acute and subacute continuum starting at the initial ED presentation. Case Report: A medically complex patient with multiple medical comorbidities and mobility deficits presenting from the home environment was evaluated by a physical therapist in the ED. The evaluation consisted of musculoskeletal and mobility assessments, as well as assistance with discharge planning. This early collaboration resulted in a streamlined workup of the patient's orthopedic problems, a positive patient experience, and a positive outcome without readmission. This patient's entire workup, rehabilitation, and safe home discharge with improved home access and quality of life occurred in the span of 6 days. Conclusion: This case describes a medically complex patient with high risk for readmission. A model of collaborative care was used by consulting a physical therapist in the ED to help address these problems, which resulted in a positive outcome. The patient reported satisfaction with his care and did not return to the hospital for mobility-related impairments. The patient and his wife/caregiver also reported improvements in quality of life because of his rehabilitation and improved mobility. All of this occurred over a short span of 6 days. The authors hope that this case will lead to further discussion and research concerning the potential positive effects of early collaborative care between providers and staff physical therapists in the ED setting.