The Role of the Physical Therapist in an Acute Care Setting

You may have seen the recent physical therapy journal (December, 2012) that was devoted to rehabilitation of people with critical illness. Those of us who have worked in an acute care setting have seen acquired weakness that seems to be greater than one would expect from prolonged bed rest, and now there is considerable evidence to support this observation.

The physical therapist’s presence in acute care/ICU can reduce the risk of adverse medical events including pneumonia, blood clots, readmission and longer lengths of stay. This has obvious impacts on hospital costs, future medical costs, overall healthcare costs and morbidity.

Intervention guidelines are now being developed to address this acquired weakness with regard to dose, contraindications, and how to progress patients safely. Patients can been seen along the way, from the ICU until discharge and continuing into the home. But we cannot rest on our laurels…we may be called upon to continue to collect evidence that includes not only function and functional improvement, but current and future costs of an episode of care. Avoiding re-admission will be an important part of this equation, with patients ending up in the proper/safe discharge location, hopefully with the recommendations of physical therapy.

We’d like to hear from you:
What has been your experience treating this population? How have you adapted to the shorter hospital stays? Do you treat in the ER? What are the biggest challenges you face in the acute care/ICU setting? What guidelines do you refer to when assessing exercise safety? Are you part of the team that determines discharge location and ensures quality transitions?