Communication Regarding Discharge (week 12)

Role of the PTA in Discharge and Discharge Planning

(4) Discharge Summary. The PT must provide final documentation for discharge of a patient, including patient response to treatment at the time of discharge and any necessary follow-up plan. A PTA may participate in the discharge summary by providing subjective and objective patient information to the supervising physical therapist.

The PTA may not:

(A) specify and/or perform definitive (decisive, conclusive, final) evaluative and assessment procedures;

(B) alter a plan of care or goals;

(C) recommend wheelchairs, orthoses, prostheses, other assistive devices, or alterations to architectural barriers to persons;

What are indications a patient might be ready for discharge?

Patient has achieved goals

Patient has plateaued

Patient is no longer appropriate for the clinical setting

* A patient may chose end treatment by declining to participate in PT or by not showing up again (outpatient)

Discharge to Home

This could be the termination of all physical therapy services or a discharge to home health physical therapy

Physical Function: Hopefully the patient is independent with ADLS, walking 100 ft and transfers

Discharge to Rehab Facility

Must be able (and willing)to participate in at least a combined 3 hours of PT/OT/ST (with breaks if needed)

Typically only for patients with comorbidities ( TKA and Stroke)

Must have potential to improve physical function

If Independent prior to injury, should have potential to return home

Skilled Nursing Facility

Often for the older population that seeks to return home

Must be willing to participate in rehabilitation

Common Dx: Stroke

Functions of Interview

Gathering information

Developing and maintaining a therapeutic relationship

Communicating information

Open-ended questions

Good way to start conversations

Follow up with clarifying statements

Not typically used as end of conversation

Interwoven Communication Tools to Enhance Patient Responses

Prompters - "Yes" "Go on"

Clarifying questions

Reflection or echoing

Paraphrasing – To confirm mutual understanding

Summarizing

When Do I Communicate with the PT?

Change in patient status

Patient has achieved goals

Patient has plateaued

Patient tells you they are ending PT services.

What to Communicate

Provide objective information, not “I feel”

Goals that are obtained

Relative subjective statements from the patient

Provide information about home environment

Provide information about family support

Necessary Steps

Patient Education/ Written Instructions

Home Exercise Program

Home Safety

Measurements

Equipment/ Assistive Devices

Allow patient opportunity to ask questions