SHM Converge Scientific Abstract ePoster Gallery-Improving Physical Therapy Utilization With Physician Assessments of Patient Mobility

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This project evaluated whether adding a physician mobility assessment using the AM-PAC “6 Clicks” tool could reduce unnecessary inpatient physical therapy (PT) consultations. PT consults are important for discharge planning, but inappropriate requests waste time, staff effort, and can delay patient care. The AM-PAC tool was already being used by therapists, but physicians were not using it to guide consult decisions.<br /><br />A retrospective review of 19,248 inpatient PT consults found that about 9% were unnecessary, defined by AM-PAC mobility scores indicating either very limited function or very good function. Roughly half of these unnecessary consults came from the hospital medicine service. In March 2022, an AM-PAC mobility questionnaire was embedded into the electronic health record for hospital medicine providers, with decision support and a requirement to complete the tool before placing a PT consult. Providers could document justification if scores fell outside the expected range.<br /><br />After implementation, unnecessary consults from hospital medicine dropped significantly, from a mean of 51% to 38% among the relevant consults, and unnecessary hospital medicine consults overall decreased from 12% to 7%. The project showed that a simple workflow change, without adding staff, can reduce waste and improve shared understanding of mobility across disciplines. The intervention was then expanded to other services, with full rollout planned by July 2023. The team is also working to improve score consistency between physicians and PT staff, since discrepancies can affect whether consults are approved.

Asset Subtitle

David J. Chung

Meta Tag

Author List David J. Chung, Kristin Masket, Louise Wall

Category Research

Concept AM-PAC 6-Clicks

Concept Physical Therapy Consult

Concept Unnecessary Physical Therapy Consultation

Concept Electronic Health Record

Concept Clinical Decision Support

Distinguished Non-Finalist

Presenter Organization LAC+USC Medical Center

Presenting Author David J. Chung

Track Quality Improvement

Keywords

AM-PAC 6 Clicks

physical therapy consults

inpatient mobility assessment

hospital medicine

electronic health record

decision support

unnecessary consults

discharge planning

workflow improvement

physician assessment

AM-PAC 6-Clicks

Physical Therapy Consult

Unnecessary Physical Therapy Consultation

Electronic Health Record

Clinical Decision Support