Improvement of Physical and Occupational Therapy Referral Process to Reduce Unskilled Consults

Purpose: Baseline data collected for 9 months showed that physical (PT) and occupational therapy (OT) services were consulted 14.5% of the time for unskilled therapy needs. The goal of this performance improvement project was to identify whether acute care physical and occupational therapists can reduce unskilled consults using a multidisciplinary education intervention. Methods: Therapists were trained on how to define and use each of 4 categories of unskilled consults. An interdisciplinary focus group was formed to gain feedback from providers with regard to the culture of mobility, the role of PT and OT, skilled versus unskilled consults, and strategies to reduce these unskilled consults. After discussion, the focus group determined that the primary strategy to reduce unskilled consults is to incorporate mobility and activities of daily living (ADL) discussion for each patient into interdisciplinary rounds (IDR). Results: Data show that PT and OT services collectively were consulted for unskilled therapy needs 3.05% of the time, compared with baseline data of 14.5%, which is a clinically meaningful decrease. Conclusion: Results provide preliminary evidence that an interdisciplinary approach using IDR can assist with reducing unskilled consults. Establishing a focus group can assist the initiatives through education on what defines an unskilled consult, collaboration, and improved communication regarding patient mobility and ADL performance while hospitalized.