Date of Award

Fall 2023

Document Type

Project Open Access

Abstract

Research Questions

1. When using section GG of the Care Tool, what items successfully predict discharge destinations?

2. What are the cut off scores for each item that determine the location when using section GG?

3. Does an increase in GG scores between admission and discharge effect the appropriate discharge destination?

It would be beneficial for inpatient rehabilitation hospitals to identify patients at admission that may be at a higher risk to discharge to a location other than home. This high-risk group could include any patient that scores below the mean for GG total score (61.2) or below the mean for GG ADL score (43). The study also identified three other indicators that could be used to classify patients into this high-risk group; increased age, decreased cognition, and living alone prior to admission. Although CMS guidelines require at least three hours of therapy on five out of seven days in an inpatient rehabilitation facility (IRF), this guideline is a minimum standard.16 Identifying patients at admission into a high-risk category would allow the IRF to devote additional therapy time and resources to these patients to try to discharge them home. All disciplines should be informed if an individual is meeting these high-risk criteria as soon as possible to facilitate interdisciplinary collaboration and attention to care. Specific GG categories that should also be specifically noted at admission during an initial evaluation by the therapy team include the patient's ability to don/doff footwear, complete toileting hygiene, complete lower body dressing, complete bed mobility, and complete transfers as these GG categories had the greatest effect size on discharge to home. Both occupational and physical therapists should target intervention sessions to treat impaired body functions and performance skills limiting independence in these categories.

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