The Effects of a Physical Therapy Triage System on the Outcomes of ICU Patients with Respiratory Failure

Abstract

Background: In September 2003, the Summa Health System implemented an activity protocol and a triage system to prioritize the delivery of physical therapy services in the intensive care unit (ICU). The triage system first identified patients who required skilled physical therapy (PT) interventions to reach the expected continuum of care level (COC) at discharge and then allocated PT services accordingly. Purpose: The purpose of this study is to answer the clinical question, “Does the triage system decrease length of stay (LOS), decrease the number of PT visits, and improve physical function while achieving the predicted COC level for patients with respiratory failure who were admitted to the ICU?” Methods: A retrospective chart review utilized a sample of 117 patients, 60 patients from January to May of 2002 (Group 1) and 57 patients from January to March of 2007 (Group 2). Group 2 was further divided into 41 Level I patients (Group 2a), 12 Level II patients (Group 2b), and 4 Level III patients (Group 2c), based on the Triage system criteria. Non-parametric tests and central tendency comparisons were used to compare the hospital LOS, ICU LOS, number of PT visits, patient function at evaluation and discharge, discharge plan at evaluation, and continuum of care level for Group 1 and 2. Results: Hospital LOS and ICU LOS were both decreased by two days and the number of PT visits per patient decreased by two sessions when comparing Groups 1 and 2. Significant changes in function from initial evaluation to discharge were shown in Group 1, Group 2a and Group 2b. Patients achieved the predicted COC level 72% of the time in Group 2. Conclusion: A physical therapy triage system can decrease patient hospital and ICU LOS, decrease the number of PT visits and achieve the predicted continuum of care level.