Exploring Therapists’ Experiences Identifying Cognitive Impairments in Post-Acute Care

Abstract

Aims Understanding therapy providers’ experiences with cognitive screening, assessment, and documentation can provide guidance on improving care quality. Methods Semi-structured interviews (n = 18) were conducted with therapy providers across disciplines and post-acute settings. Thematic analysis was used to identify themes. Results Six over-arching themes emerged pertaining to cognitive screening and assessment. (1) Therapists routinely conducted screening through task performance and informal observation. (2) Documentation habits varied due to multiple conflicting goals and lack of guidelines. (3) Therapists’ approach was honed on the job through clinical experience and trial and error. (4) Patient diagnosis, emerging medical conditions, and goals most strongly influenced therapists’ approach. (5) Roles and responsibilities were implicit. (6) The end goal was determining patient safety. Conclusion All therapy providers frequently screened for cognition, yet documentation varied widely. To increase consistent delivery and documentation of cognitive screening and assessment, future studies can examine strategies to streamline electronic health record platforms.