by Misty Kevech, HHQI RN Project Coordinator
HHQI would like to specifically thank all physical therapists (PTs) and assistants (PTAs) in honor of National Physical Therapy Month (#ChoosePT). In home health, physical therapists are valuable interdisciplinary team members that provide care to more than orthopedic or mobility issue patients. Physical therapists can assist with disease management, such as heart failure, by improving the patient’s strength and endurance to allow for a higher quality of life.
I have been very fortunate to have worked or partnered with a great number of amazing and caring physical therapists from clinical to administrative settings over the years. Often home health agencies don’t utilize therapists to their full scope of practice, or clinicians work in silos of care vs. an integrated system. But I have worked with organizations that embrace the value of therapists as wound care specialists, educators, quality improvement experts, and as leaders. Integration of therapists into an active care management team goes way beyond interdisciplinary team (IDT) reports via email or phone; it is creating a true interdisciplinary care team.
Therapists come to the table with the perspective of evidence-based practices, objective measurement, goal setting, and a plan-of-care focused approach. Those skill sets are critical in our evolving healthcare environment to improve the quality of care, increase patient satisfaction, and to reduce costs (Triple Aim concept).
Primarily my experiences and partnerships with physical therapists have been in the home health setting. Recently, I was able to experience therapy from a patient’s perspective. I put off having knee replacement surgery as long as I could, but this summer, I could not put it off any longer. I was not worried about the procedure as much as how the process was going to affect my life and job during the rehab process. What surprised me the most was how much I learned during this process.
I really did not have much experience with a total knee replacement beyond doing the start of care, medication/pain/incision care education, and the removal of the staples. I have reviewed many knee/hip replacement patient records for quality improvement but did not understand the post-op process for a total knee from the lens of a patient.
My patient journey started with a pre-op class at the hospital which was taught by a nurse and a therapist. I was thrilled to see evidence-based practices integrated into the acute and post-acute care plans. I learned not just how to perform the pre-op exercises but why they were important for the success of my rehab. The therapists said that it would be very obvious to identify who did and who did not do the pre-op exercises (that was so true). We were provided with detailed information on what to expect with therapy, evidence-based practices, goals, and hospital mile markers toward discharge. A home assessment was completed weeks prior to surgery so that needs were identified early and strategies could be in place to facilitate a good transition home.
As a patient, it was reassuring to know what was expected and planned. The planned goal for the day of surgery was to walk to the door of my room. That did not sound so bad during class – and it really was not bad at all. In fact, I did really well and was able to walk down the hall. The rehab team had a mile marker magnetic board with a tennis shoe magnet for each patient to track distances, which was a great idea for a visual to get to the ambulation goal for discharge. So I was off and running! I participated in group therapy the next morning and found it to be very beneficial. Other patients shared previous experiences or tips for doing the exercises at home. Because my therapist recommended an early discharge for me, the team worked efficiently to obtain discharge orders and make an earlier outpatient appointment.
My outpatient therapy experience was great. The PTs and PTAs worked hand-in-hand to adjust my therapy, attend to my medical needs, answer my many questions, and encourage me toward my goals. I watched other patients who were similar to our home health population as they progressed through their rehab. The therapists guided and encouraged these patients with a caring attitude.
This year, National Physical Therapy Month is more meaningful to me. I have a higher appreciation of what all therapists do, no matter the setting.
HHQI would like to thanks all the therapists that we’ve had the pleasure to work with over the past 10 years. We would also like to share some great resources related to expanding the role of the physical therapists within their scope of practice.
- HHQI Webinars
- HHQI University Courses (includes free nursing CEs and PT CCUs)
- Exercise Prescription for the Home Health Patient with Heart Failure (Dee Kornetti & Cindy Krafft)
- Maintenance therapy for the Home Health Patient with Heart Failure (Dee Kornetti & Cindy Krafft)