Prioritizing case load

[kishorenidadavolu]

Hi, are there any guidelines or procedure for priorotizing case load in an acute hospital facility? For example post op and ready to discharge patients: Who will you treat first and what is the rationale behind? and also musculo and neuro case load.. any thoughts???

[alophysio]

I have always lived by these rules...

1. Treat the ones who will die if i do not see them. Since we are physios, let's face it, we don't have a lot of these patients at all!
2. Treat the ones who will get worse if i do not see them. We see lots of these - ICU, ortho postop, resp patients, stroke etc.
3. Treat the ones who will not get to see me again. These are your D/C patients who need the advice etc. Hopefully you have been training them on what they need to do when they get home before they are even thought of being discharged!
4. Treat the ones that are left. Let's face it, these people won't mind having a day off physio if you run out of time. They are getting better anyway and are doing their exercises.

Hope it helps.!

[kishorenidadavolu]

Hi thanks for the reply, my friend has forwarded a prioritizing criteria which they follow in pediatric neuro..its as below..

CATEGORY DESCRIPTION SCORE

A) AGE

• 0-2 YRS 3
• 2-5 YRS 2
• 6-11 YRS 1
• 12+

B) DIAGNOSIS:

• NEW/ACUTE 3
• RECURRING/DETRIORATING/CHRONIC 2
• MINIMAL /STABLE 1

C) Reason for referral:

• ACUTE/LIFE THREATNING 3
• PREVENTIVE 2
• FUNCTIONAL 1

OTHER INFORMATION

• SOCIAL/CHILD PROTECTION/TRANSITION/ENVIRONMENTAL/PHYSICAL DETRIORATION 3
• UNABLE TO KEEP UP WITH PEERS/DISREPANCY BETWEEN MOTOR AND COGNITION/UNABLE TO FUNCTION AT HOME 2
• LITTLE OR NO RISK OF IMPAIRMENT 1

[psychophysio]

When I worked in Orthopaedics is was:
1. Day 1 post-ops and discharges (sometimes the same people!)
2. Routine post-ops and stable spinals (eg TKJR, THJR)
3. Mobility patients

In medical:
1. Any new respiratory pts or who will die without me seeing them (not many on the wards)
2. Follow-ups from 1, new mobility referrals
3. Ongoing mobilities, rehab on ward pts waiting to go to rehab

In Acute neuro:
1. New patients and anyone at risk of respiratory deterioration (eg GBS)
2. Follow-ups who will deteriorate if not seen
3. Rehab on ward patients

In Surgical and ICU:
1. ICU patients and surgicals at risk of deterioration
2. New post-op surgicals
3. Mobilities and rehab (eg fem-pop bypasses)

I liked alophysios list too for keeping it simple

[sdkashif]

Yeah good information and feedback here to the reply. But what does the Guide for the Practice of Physical Therapist emphasize regarding that? Please, mention some relevent information from that if any?

[Silkysplinter]

I've just started a physio degree in the have a case study