HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when Rapid Responses are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Jette, D. U Articles by Keck, C. P Search for Related Content PubMed PubMed Citation Articles by Jette, D. U Articles by Keck, C. P Related Collections Coordination, Communication, and Documentation Clinical Decision Making Social Bookmarking                      What's this?

A Qualitative Study of Clinical Decision Making in Recommending Discharge Placement From the Acute Care Setting

DU Jette, PT, DSc, is Professor and Program Director, Physical Therapy Program, Graduate School for Health Studies, Simmons College, Boston, Mass, and Research Coordinator, Department of Rehabilitation Services, Beth Israel Deaconess Medical Center, Boston, Mass.
L Grover, PT, is Team Leader, Inpatient Rehabilitation Services, Beth Israel Deaconess Medical Center
CP Keck, OTR/L, is Clinical Manager, Inpatient Rehabilitation Services, Beth Israel Deaconess Medical Center

Address all correspondence to Dr Jette at Simmons College, 300 The Fenway, Boston, MA 02115 (USA) (diane.jette{at}simmons.edu)

Background and Purpose. One of the roles of rehabilitation professionals in the acute care setting is making recommendations for patients' discharge placement. The purpose of this investigation was to explore the decision-making process of physical therapists and occupational therapists when recommending discharge destination for patients following acute care hospitalization. Subjects. Participants were 7 physical therapists and 2 occupational therapists in an acute care rotation at a large academic medical center. Methods. A grounded-theory strategy was used. Three interviews were conducted and guided by questions about participants' approaches to discharge decision making. Information from the interview transcripts was used to define constructs. A model was generated to explain the relationships among the constructs. Results. Decision making regarding discharge recommendations was guided by 4 constructs: patients' functioning and disability, patients' wants and needs, patients' ability to participate in care, and patients' life context. Information was filtered through therapists' experiences and modified by the health care team's opinions and by health care regulations. Discussion and Conclusion. The decision making of the rehabilitation professionals studied in recommending discharge placements for their patients reflects consideration of patients as individuals and the environments in which they live. Information about patients is filtered through the experience of therapists and influenced by health care regulations and opinions of other health care professionals, the patients, and their associates. The findings might be used in teaching clinical decision making to clinicians and students as they learn to make discharge recommendations.

Key Words: Decision making • Patient care planning • Patient discharge

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				D. U. Jette, R. Brown, N. Collette, W. Friant, and L. Graves Physical Therapists' Management of Patients in the Acute Care Setting: An Observational Study Physical Therapy, November 1, 2009; 89(11): 1158 - 1181. [Abstract] [Full Text] [PDF]

				N. M. Salbach, S. J.T. Guilcher, S. B. Jaglal, and D. A. Davis Factors Influencing Information Seeking by Physical Therapists Providing Stroke Management Physical Therapy, October 1, 2009; 89(10): 1039 - 1050. [Abstract] [Full Text] [PDF]

				N. M. Salbach, P. Veinot, S. Rappolt, M. Bayley, D. Burnett, M. Judd, and S. B. Jaglal Physical Therapists' Experiences Updating the Clinical Management of Walking Rehabilitation After Stroke: A Qualitative Study Physical Therapy, June 1, 2009; 89(6): 556 - 568. [Abstract] [Full Text] [PDF]

				P. Q McGinnis, L. M Hack, K. Nixon-Cave, and S. L Michlovitz Factors That Influence the Clinical Decision Making of Physical Therapists in Choosing a Balance Assessment Approach Physical Therapy, March 1, 2009; 89(3): 233 - 247. [Abstract] [Full Text] [PDF]

				N. M Salbach, S. B Jaglal, N. Korner-Bitensky, S. Rappolt, and D. Davis Practitioner and Organizational Barriers to Evidence-based Practice of Physical Therapists for People With Stroke Physical Therapy, October 1, 2007; 87(10): 1284 - 1303. [Abstract] [Full Text] [PDF]

				D. J Vreeman, S. L Taggard, M. D Rhine, and T. W Worrell Evidence for Electronic Health Record Systems in Physical Therapy Physical Therapy, March 1, 2006; 86(3): 434 - 446. [Abstract] [Full Text] [PDF]