Reassessing a patients situation

Although the patient involved in this situation was not in my care it drew to my attention a situation which is not uncommon in the public health sector that is likely to result in poor patient outcome.

A patient who had a stroke was admitted to the hospital I was on prac at and acute care provided, however the initial plan was for transfer to a rehabilitation ward at a different hospital. The patient was seen by a physiotherapist who performed an assessment, some basic ROM exercises and repositioning of the patient. At this point it was assumed that the patient would receive the necessary rehab elsewhere in the next day or so and was effectively discharged from physio services on that ward. There were complications (not related to the patients status) which prevented immediate transfer to the rehab unit for more than a week, during which time the patient was hoisted on the ward and not given any form of rehabilitation from allied health.

This situation can easily occur if patients are not re-referred from the coordinating staff when discharged from a particular service such as physio, or if the judgement that it has been too long to continue waiting on a future service is not made. In most cases allied health professionals will review the ward lists and enquire as to why a patient has not been discharged after the intended period, however this needs to be common practice to ensure that a patient receives rehab as soon as feasibly possible to maximise outcomes.