Citation

Hitzig SL, Gotlib Conn L, Guilcher SJT, Cimino SR, Robinson LR. Disabil. Rehabil. 2020; ePub(ePub): ePub.

Affiliation

Division of Physical Medicine and Rehabilitation, Faculty of Medicine, University of Toronto, Toronto, Canada.

Copyright

(Copyright © 2020, Informa - Taylor and Francis Group)

DOI

10.1080/09638288.2020.1719215

PMID

32017865

Abstract

Purpose: Transitions across care settings can be stressful for trauma patients, and when poorly executed, can lead to poor outcomes. Early physical medicine and rehabilitation (PM&R) consults in acute care settings can optimize the continuum of care for trauma patients, but there is a need for additional insight on its impact. This study aimed to better understand how early PM&R consults influence the continuum of care between acute and rehabilitation trauma settings.Methods: Four focus groups were conducted with 21 trauma acute care and rehabilitation staff, and data were analyzed via content analysis.Results: The main themes identified were: (1) patient-level considerations (i. readiness for rehab [mental health]; ii. patient education and expectations for rehab); (2) clinical-team considerations (i. physiatry role clarity and role limitations; ii. access and accuracy of information; iii. departmental silos); and (3) system-level considerations (i. occupancy and discharge pressures; ii. inter-facility coordination and patient flow).Conclusions: Although both acute and rehabilitation care staff find early PM&R consults as being important to support the recovery of trauma patients, there is a need for greater role clarity of the physiatrist across settings and a more refined implementation approach to better meet the communication needs of clinical staff. Implications for RehabilitationEarly physical medicine and rehabilitation consults are seen by acute care and rehabilitation front-line staff as valuable for optimizing the continuum of trauma care.There is a lack of clarity on the role of physiatrists among acute care and rehabilitation clinical staff.The physiatrist plays an important role to help prepare trauma patients for rehabilitation. For patients with complex physical and/or mental health challenges, the physiatrist can also serve as an advocate for access to rehabilitation services.

Language: en

Keywords

Wounds and injuries; continuity of patient care; physiatrists; physical and rehabilitation medicine; qualitative research