Allied Health Consults

Please do not discuss this project 
with other staff except collectors 
at your sites.  
This project will observe staff 
behaviour and we are concerned about a 
Hawthorne effect. 

Purpose

To determine how many allied health consults patients are getting, in part to determine the effect of the Overstay Predictor Project on this variable.

We want to collect whether a consult was requested, not what sort of delays happen. That is something we know we need to consider, but it is not part of this temporary collection. We assume that most patients get allied health consults but we need numbers to back up the assumption.

Audit Dates

• Starting: TBD, early Nov
• Ending: 3- 4 weeks after start date

Collection Instructions

Generate a tmp entry for the first relevant allied health discipline if they had a consult

- while admitted to your ward (ie after admission, before discharge)

- in the ER immediately prior to admission to your ward

• Project:AlliedHC
• Item (as appropriate):
  • Home Care
  • Physio
  • OT
  • Social work
• no other fields need to be filled, i.e. no times etc.

Data use and analysis

The data will be analyzed as part of the Overstay project. Tina is involved with that and can provide it directly.

Collector observations and comments that might help interpretation of this data

I will treat these as comments only, unless you put a {{discussion}} tag and a question I could address.

At the Vic, non-teaching medicine spends much of its time on discharge planning. PT and OT are often consulted in emerg and patients are usually assessed in emerg. If a patient does not pass the function assessment, the patient will be admitted to a ward. The patients here are sometimes admitted for failure to cope in the community. They are followed up on the ward usually the next day or when the patient's medical condition improves enough for the patient to participate. I notice that a patient may be medically stable but not able to perform ADL (activities of daily living)due to deconditioning. Discharge will be delayed till the patient has plateaued or gained a prior level of ADL functioning. This is the first significant delay in patient discharge that I see and holds up discharge planning for weeks. It can take weeks or more for the patient to regain strength. PT and OT work together and will consult each other on the patient's progress. Once PT feels that the patient is mobilizing well, OT will complete their assessment and determine the type of supported needed in the home if home is the goal. Home Care (HC) becomes involved once the patient has plateaued and makes the needed arrangements. The home care process seems fast and efficient in my opinion; usually a matter of 2-3 days approx. this is of course when the patient is returning to a prior living arrangement. When a patient fails to meet the criteria to return home or needs supportive housing a second delay begins. Paneling is the third time consuming process and waiting for placement seems to take months. These are the three main delays I see here at the Vic on my non-teaching units. What do others see happening? Jkublick Nov 1, 2012.

• Decided to include consults in ER immediately prior to ward admission. Ttenbergen 15:59, 2012 November 1 (EDT)