SHM Converge Scientific Abstract ePoster Gallery-Effectiveness of Mobility Score-Based Clinical Decision Support for Optimizing Inpatient Physical Therapy Utilization on Hospital Medicine Services

Effectiveness of Mobility Score-Based Clinical Decision Support for Optimizing Inpatient Physical Therapy Utilization on Hospital Medicine Services

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This study examined whether an AM-PAC 6-Clicks–based clinical decision support (CDS) tool could reduce unnecessary inpatient physical therapy (PT) consults on hospital medicine services. PT is important for preventing hospital-associated deconditioning, but it is often overused in patients who are already highly mobile. The AM-PAC 6-Clicks score is a validated mobility measure frequently documented by nurses and can help identify patients who are unlikely to need inpatient PT.<br /><br />Researchers embedded the CDS tool into hospital medicine note templates so that providers had to review and document mobility status based on the auto-populating AM-PAC score. They compared PT referral patterns before the intervention (October 2018–September 2019) and after implementation (February 2020–March 2021), focusing on patients with high mobility scores, defined as AM-PAC ≥18.<br /><br />Among 6,047 patients, the post-intervention period showed a lower PT referral rate for high-mobility patients than the pre-intervention period (35.0% vs 40.3%). In multivariable analysis controlling for pandemic period, admissions per month, length of stay, and PT consult volume, the CDS tool was associated with significantly lower odds of PT referral over time (adjusted OR around 0.75–0.77, p=0.01). This corresponded to a 5.3% decrease in inappropriate PT consults after implementation.<br /><br />The authors conclude that EMR-based CDS alone, without additional education, can reduce PT consults for high-mobility patients and that the effect may persist over time. They recommend that hospitalists consider mobility score-based CDS to optimize inpatient PT use.

Asset Subtitle

Maylyn S. Martinez

Meta Tag

Author List Ameerah Brown, Andrew W. Schram, David O. Meltzer, Mahnoor Baig, Marla R. Robinson, Matthew Cerasale, Maylyn S. Martinez, Vineet Arora

Category Research

Concept AM-PAC 6-Clicks Bedside Tool

Concept Physical Therapy Utilization

Concept Clinical Decision Support

Concept Inpatient Physical Therapy Referral

Concept Hospital EMR

Distinguished Non-Finalist

Presenter Organization University of Chicago

Presenting Author Maylyn S. Martinez

Track Quality Improvement

Keywords

AM-PAC 6-Clicks

clinical decision support

inpatient physical therapy

hospital medicine

mobility score

PT consults

electronic medical record

high-mobility patients

referral reduction

hospital-associated deconditioning

AM-PAC 6-Clicks Bedside Tool

Physical Therapy Utilization

Clinical Decision Support

Inpatient Physical Therapy Referral

Hospital EMR