Physical Therapist Prediction Accuracy of Discharge Placement from Acute Care.
Background: The clinical impression of the Physical Therapist is requested in the determination of patient placement after an acute stroke. There is little evidence to determine if physical therapists are accurately making these recommendations. Also, there is little consensus regarding factors physical therapists consider when making these decisions. It is unknown if years of clinical experience affects placement judgment. The purpose of this retrospective chart review was to address the following questions: How accurate were the physical therapists in predicting placement and did experience affect the accuracy of the prediction? Methods: A retrospective chart review of 64 medical records of persons admitted to The University of Pittsburgh Medical Center Stroke Institute during 1999 was conducted. Data collected included client demographics, elements of the medical and social history, and measures obtained from the initial evaluation and the therapist s recommendation for discharge placement. Results: Spearman rank correlation coefficients were calculated between the predicted and actual discharge location, and to determine the association of the accuracy of prediction and other factors from the client s history or evaluation.An accurate prediction was made 73 % of the time. A moderate correlation was found between the predicted and actual discharge location. (r =.655). Fair but significant correlations were found between the accuracy of prediction and the following factors: the extent of brain damage (r=-.423), bowel and bladder function (r= .357), National Institutes of Health Stroke Scale score (r=.391), and the client s abilities to perform balance (r=.399), sit to stand (r=.483), and locomotion (r=.411). No significance was found between the therapist s years of experience and correct placement decisions. Physical therapists with a minimum of 3 years of experience evaluated 77% of the patients.. Conclusions: In this retrospective chart review, physical therapists were accurate in their predictions of placement location for persons with an acute stroke. The physical therapists years of experience did not appear to significantly affect accuracy