Extra Physical Therapy Reduces Patient Length of Stay and Improves Functional Outcomes and Quality of Life in People With Acute or Subacute Conditions: A Systematic Review

Peiris, Casey L; Taylor, Nicholas F.; Shields, Nora

doi:10.1016/j.apmr.2011.04.005

Cited by 120 publications

(112 citation statements)

References 58 publications

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“…[17][18][19] It has also been shown that increasing the amount of physiotherapy, such as providing an increased number of weekly sessions, can have a positive association with improving other patient outcomes in acute and sub-acute settings. 20,21 The results from the current study in the TCP setting is consistent with those from previous research, in that an increased amount of physiotherapy is associated with improved patient and health service outcomes. The specific type of physiotherapy intervention potentially varied between TCPs, and contained elements of the following aspects of physiotherapy management: mobility training, skill training exercise prescription, group exercise sessions, caregiver training, education and discharge planning.…”

Section: Discussionsupporting

confidence: 89%

Factors that predict discharge destination for patients in transitional care: a prospective observational cohort study

Brusco

Taylor

Hornung³

et al. 2012

Aust. Health Review

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Objective. To investigate factors that predict discharge destination for patients making the transition from hospital to the community.Methods. Using a prospective cohort design, 696 patients from 11 Transition Care Programs were recruited. Baseline patient and program characteristics were considered for predicting discharge destination, functional status, and patient length of stay.Results. An increased physiotherapy staffing ratio in Transition Care Program was associated with an increased likelihood that a patient was discharged home, with an improved functional or mobility status, and after a shorter length of stay. The other factor that predicted discharge to home included having an Aged Care Assessment Service classification of low level care or home with a support package. An increased physiotherapy staffing level also reduced the likelihood of discharge to low level or high level care. The other factors that predicted discharge to low level care were having higher mobility status and older age; the other factor associated with increased likelihood of predicting discharge to high level care was having an Aged Care Assessment Service classification of high level care.Conclusions. Factors on admission that predicted discharge destination were program physiotherapy staffing ratios, Aged Care Assessment Service assessment, age and mobility status. What is known about the topic? In 2004/05 Australia introduced a program called the Transition Care Program (TCP), which targets older persons at the conclusion of an acute hospital episode who require more time and support in a non-acute setting to complete their restorative process and optimise their functional capacity. This program has a particular objective to prevent inappropriate admission to a residential aged care facility. To date, there are no published papers that report the factors that predict discharge destination for patients in the Transition Care Program. What does this paper add? This study provides evidence that program physiotherapy staffing ratios, Aged Care Assessment Service assessment, age and mobility status are predictive of an increased likelihood that a patient will be discharged home with an improved functional/mobility status, after a shorter length of stay. What are the implications for practitioners? Knowledge of factors that predict discharge destination may assist healthcare practitioners and health managers in managing TCP patients and planning services.

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Section: Discussionsupporting

confidence: 89%

Factors that predict discharge destination for patients in transitional care: a prospective observational cohort study

Brusco

Taylor

Hornung³

et al. 2012

Aust. Health Review

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“…effect of extra physiotherapy on people with acute or subacute conditions was also identified. 33 One paper in the reference list was obtained in full text, but it was ineligible because the additional therapy was provided within business hours. 34…”

Section: Papers Included In Review (N = 7)mentioning

confidence: 99%

After-hours or weekend rehabilitation improves outcomes and increases physical activity but does not affect length of stay: a systematic review

Scrivener

Jones

Schurr

et al. 2015

Journal of Physiotherapy

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“…swallowing dysfunction, functional decline or medication error), mitigating length of stay and facilitating effective discharge. [5][6][7] Economic evaluations have shown that increasing allied health services in subacute settings reduces patient 'length of stay' and reduces medication error, providing large cost savings at the health service and health system levels. 5 More recently, allied health is increasingly supporting medical specialists through advanced roles in a range of settings, such as emergency, outpatient clinics, triaging and managing less complex cases requiring conservative management.…”

Section: Issuesmentioning

confidence: 99%

“…[5][6][7] Economic evaluations have shown that increasing allied health services in subacute settings reduces patient 'length of stay' and reduces medication error, providing large cost savings at the health service and health system levels. 5 More recently, allied health is increasingly supporting medical specialists through advanced roles in a range of settings, such as emergency, outpatient clinics, triaging and managing less complex cases requiring conservative management. [8][9][10][11] Although not yet 'usual hospital practice', these cost-effective models reduce waiting times, improve patient flow and quality of care making them a 'no-brainer' in health services working to manage increased demand.…”

Section: Issuesmentioning

confidence: 99%

Allied health: untapped potential in the Australian health system

Philip¹

2015

Aust. Health Review

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Although comprising around 20 per cent of Australia's health care workforce, allied health and its contribution to improving health outcomes remains poorly understood and largely invisible in the Australian health policy and reform environment. There is strong evidence demonstrating the benefits of allied health in improving patient outcomes, minimising risk and harm from illness and improving health system efficiency and capacity to meet increased demand cost effectively. Despite this, the existing health model, funding and culture prevent us from effectively accessing these benefits at a system level. The untapped potential of allied health represents a major underutilised resource to address many of the challenges facing Australia's health system today. A transformational change in the Australian health system in how, where and by whom care is provided is necessary. Australia's health model and culture needs to shift, to genuinely involve the consumer and make full use of all three pillars of the patient care workforce. IntroductionAllied health, medicine and nursing together constitute the patient care workforce, each workforce element bringing unique and necessary skills to provide high-quality, patientcentred care. The three workforces can be considered as the three pillars of the patient care workforce, each being equally necessary for the stability, functioning and outcomes of the whole. Despite this, the allied health pillar is largely overlooked at a systems level in Australia. The unrealised potential of allied health represents a major underutilised resource to address many of the challenges facing our health system today. Better use of the allied health workforce can improve health outcomes and reduce overall health system costs by reducing demand and utilisation of acute health facilities.1 Despite the solutions inherent in this resource, our health system remains unable to access them due to the health system's traditional medical model and focus on acute, episodic care. The health system must adapt in order to meet its core purpose of improving health outcomes and meeting the Australian community's health care needs in a sustainable way. The solutions lie in being clever in using the resources at its disposal, including allied health, to best effect.

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Extra Physical Therapy Reduces Patient Length of Stay and Improves Functional Outcomes and Quality of Life in People With Acute or Subacute Conditions: A Systematic Review

Cited by 120 publications

References 58 publications

Factors that predict discharge destination for patients in transitional care: a prospective observational cohort study

Factors that predict discharge destination for patients in transitional care: a prospective observational cohort study

After-hours or weekend rehabilitation improves outcomes and increases physical activity but does not affect length of stay: a systematic review

Allied health: untapped potential in the Australian health system

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