Increased physician and physical therapist communication is associated with earlier mobility and decreased length of stay in the cerebrovascular and trauma neuroscience population
Affiliations: [a]
Department of Rehabilitation Services, UK Healthcare, UK
| [b] Department of Physical Medicine and Rehabilitation, University of Cincinnati, Cincinnati, OH, USA
| [c] Department of Neurological Surgery, University of Kentucky, Lexington, KY, USA
| [d] Department of Neurology, University of Kentucky, Lexington, KY, USA
| [e] Department of Radiology, University of Kentucky, Lexington, KY, USA
| [f] Department of Neuroscience, University of Kentucky Lexington, KY, USA
Correspondence:
[*]
Address for correspondence: Justin F. Fraser, MD, FAANS, FAHA, Director of Cerebrovascular Surgery, Asst Professor of Cerebrovascular, Endovascular, and Skull Base Surgery, Departments of Neurological Surgery, Neurology, Radiology, and Neuroscience, University of Kentucky, 800 Rose St. Room MS105A, Lexington, KY 40536, USA. Tel.: +1 859 323 0616; E-mail: jfr235@uky.edu.
Abstract: OBJECT:Recent efforts in neurocritical care have emphasized optimal timing and employment of rehabilitation services. However, there is sparse literature on the effect of team approaches to the intensive care patient. The aim of this study was to evaluate the effect of increased coordination between a physical therapist and an attending cerebrovascular neurosurgeon through daily multidisciplinary rounds. METHODS:A retrospective review was performed of 235 patients who were admitted to the neuroscience service under a single cerebrovascular neurosurgeon over a 16-month period (April 2014 through July 2015) in a level-I trauma hospital. The study consisted of an eight-month pre-intervention period (n = 117) where the physical therapist did not attend physician rounds and an eight-month post-intervention period (n = 118). RESULTS:In the post-intervention group the physical therapy (PT) assessment occurred on average 1.57 days sooner (p < 0.001). Hospital Length of Stay (LOS) decreased by an average of 3.46 days (p = 0.04) and ICU LOS decreased on average by 1.83 days (p = 0.05) in the post-intervention group. Ventilator days decreased on average by 0.55 days, which was not statistically significant (p = 0.26). CONCLUSIONS:In conclusion, daily coordination with multidisciplinary rounds between the physician and the physical therapist was associated with decreased time to initial PT assessment, decreased hospital LOS, and decreased ICU LOS in the neuroscience population.
Keywords: Neurocritical care, physical therapy, rounding, communication, length of stay
