According to a recent analysis, the pressures of an aging US population should cause emergency departments (EDs) to rethink delivery of care based on cooperative interdisciplinary decision-making, including comprehensive discharge planning involving physical therapists (PTs) when appropriate.
The report, "Transforming Emergency Care for Older Adults," (abstract only available free) appears in the December 2013 issue of the health care policy journal Health Affairs and describes how EDs can respond to the "silver tsunami" affecting nearly all areas of health care. The article's authors assert that success will require EDs to seize "opportunities to transform the emergency department's … role as the 'front door' of the hospital to becoming the 'front porch,'" where treatment is provided with attention to what happens after the patient leaves the ED.
Among the recommendations included in the analysis are the use of evaluative measures of cognitive function and discharge risk assessments, and the creation of "comprehensive discharge planning that includes shared decision-making." The plan should also include a high level of involvement with care transitions and "appropriate specialty consultation, such as physical therapy or home services, or both," authors write.
The article warns that these new models of care for EDs that employ "much needed care-coordination" could, in the short term, increase ED lengths-of-stay and costs. However, authors assert that the changes create an opportunity for "pivotally improving patient health outcomes and facilitating optimal shared decision making while reducing admissions, ED revisits, and overall care costs."
Health Affairs recently held a briefing on the latest thoughts on EDs, and has made video and other materials available online for free. PTs can find out more about the integral role of physical therapists in emergency care at APTA's webpage devoted to physical therapy practice in EDs.
APTA member Julie Keysor, PT, PhD, has been elected to lead the Physical Activity Work Group of the Osteoarthritis Action Alliance (OAAA). APTA is a member of the alliance.
Keysor is the director of the Center for Enhancing Activity and Participation Among Persons With Arthritis at Boston University. She is a member of APTA's Geriatrics, Orthopaedics, and Research sections.
The Osteoarthritis Action Alliance is a national coalition of concerned organizations mobilized by the Arthritis Foundation and the Centers for Disease Control and Prevention.
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