Physical Therapy Non-Treatment of the Acute Hospital Inpatient

Abstract

This was a retrospective analysis of therapist documentation from every patient with orders for physical therapy in a Midwestern hospital over 4 years. Not all scheduled physical therapy treatment sessions result in actual treatment in the acute care hospital. Little is known regarding rates and reasons for patient non-treatment in physical therapy in this setting. As physical therapy can impact patient outcomes and length of stay for patients, a greater understanding is needed on the non-treatment phenomenon. Objective: To describe rates and reasons for patient non-treatment in physical therapy in an acute care hospital. Documentation regarding scheduled treatments, treatments not administered (non-treatment), and the reasons for non-treatment were reviewed. Reasons for non-treatment were grouped as follows: (1) patient refused, (2) patient condition contraindicated therapy, (3) patient scheduling (patient was unavailable), (4) insufficient staffing, (5) patient had been discharged from the hospital, (6) patient expired, and (7) unknown. The average non-treatment rate was 15.3%. The most common reasons were condition (37.8%), refused (27.6%), and scheduling (26.6%). Non-treatment occurred in nearly one of seven scheduled therapy sessions with potential negative consequences for patients, physical therapy departments and the acute care hospitals in which they function. More research is needed to explore the factors that contribute to non-treatment and to identify effective ways to reduce the rate of non-treatment.