Resumen
Este estudio cualitativo exploró la perspectiva del personal de emergencia sobre la consulta de fisioterapia (PT) en el departamento de emergencia (ED) para adultos mayores con caídas.
Se identificaron varios temas comunes, como la valoración de la experiencia y el tiempo de los fisioterapeutas, la facilitación del flujo de pacientes y la mejora del seguimiento ambulatorio.
También se señalaron desafíos comunes, como la falta de personal y espacio para evaluaciones de PT en ED.
Para abordar estos desafíos, se sugieren estrategias como la promoción de la adquisición de liderazgo y la creación de espacios designados para la consulta de PT en los departamentos de observación de ED.
Consulta de fisioterapia en emergencias para adultos mayores
La consulta de fisioterapia en el departamento de emergencias resulta crucial para adultos mayores con caídas. Implementar programas de educación y vías de consulta formales en clínicas de fisioterapia puede mejorar la atención al paciente y reducir visitas repetidas, beneficiando a pacientes y profesionales.
Abstract original
Physical therapy consultation in the emergency department for older adults with falls: A qualitative study
Objectives: Little is known about current practices in consulting physical therapy (PT) in the emergency department (ED) for older adults with falls, a practice that can reduce fall-related ED revisits. This qualitative study aimed to understand perspectives of ED staff about ED PT consultation for older adults with falls and fall-related complaints, specifically regarding perceived value and associated challenges and strategies.
Methods: We performed focus groups and key informant interviews with emergency physicians, advanced practice clinicians, nurses, physical therapists, occupational therapists, and technicians who perform ED geriatric screenings. We used rapid qualitative analysis to identify common themes related to decisions to consult PT from the ED, perceived value of PT, and common challenges and strategies in ED PT consultation.
Results: Twenty-five participants in 4 focus groups and 3 interviews represented 22 distinct institutions with ED PT consultation available for older adults with falls. About two thirds of EDs represented relied on clinician gestalt to request PT consultation (n = 15, 68%), whereas one third used formal consultation pathways (n = 7, 32%). Participants valued physical therapists' expertise, time, and facilitation of hospital throughput by developing safe discharge plans and contact with patients to improve outpatient follow-up. Common challenges included limited ED PT staffing and space for PT evaluations; strategies to promote ED PT consultation included advocating for leadership buy-in and using ED observation units to monitor patients and avoid admission until PT consultation was available.
Conclusion: ED PT consultation for older adults with falls may benefit patients, ED staff, and hospital throughput. Uncertainty remains over whether geriatric screening-triggered consultation versus emergency clinician gestalt successfully identifies patients likeliest to benefit from ED PT evaluation. Leadership buy-in, designated consultation space, and formalized consultation pathways are strategies to address current challenges in ED PT consultation.
| Autores | Anita Chary Elise Brickhouse Beatrice Torres Lauren Cameron-Comasco Sangil Lee Brittany Punches Rachel M Skains Aanand D Naik Catherine C Quatman-Yates Maura Kennedy Lauren T Southerland Shan Liu |
| revista | J Am Coll Emerg Physicians Open |
| DOI | 10.1002/emp2.12941 |