Patient Management Model Flashcards
an ongoing, iterative process that focuses on the evolving needs of each individual.
PATIENT & CLIENT MANAGEMENT
Application of the PATIENT & CLIENT MANAGEMENT model
to rehabilitate, habilitate, maintain health or function, prevent functional decline, and, in healthy individuals, enhance performance.
The process of patient management has five basic components.
A comprehensive EXAMINATION
EVALUATION of data collected
Determination of DIAGNOSIS based on impairments, functional limitations, and disability
Establishment of a PROGNOSIS and plan of care based on patient-oriented goals
Implementation of appropriate INTERVENTION.
TLDR; collection of data
EXAMINATION
Systematic process by which a therapist obtains information about a patient’s problems and his or her reasons for seeking physical therapy services
EXAMINATION
Means by which baseline measurements of current impairments, functional limitations, and abilities are established as a reference point for which therapeutic interventions can be measured and documented.
EXAMINATION
T or F
EXAMINATION B4 INITIAL INTERVENTION IS A MUST
TRUE
DISTINCT ELEMENTS OF COMPREHENSIVE EXAMINATION (3)
health history
systems review
tests and measures
Overview of current & past information about a patient’s present condition, general health, & why patient sought physical therapy services.
HISTORY
In history taking, Sources of information are?
✓ Self-report health history questionnaires
✓ Interviews
✓ Review of Medical Record
✓ Reports from referral source
Report involving the overall physical and emotional wellbeing of the patient
Narrow down factors which contribute to the patient’s current condition
SYSTEMS REVIEW
Brief relevant screening of the body systems.
Systems typically screened are; cardiovascular, pulmonary, integumentary, musculoskeletal, and neuromuscular.
SYSTEMS REVIEW
General overview of a patient’s cognition, communication, and social/emotional responses. o Anatomical & Physiological
Systems review
Provides in-depth information about impairments, functional limitations, & disabilities.
SPECIFIC TESTS & MEASURES
Enables a therapist to support or refute the working hypotheses formulated while taking the patient’s health history & performing the systems review.
SPECIFIC TESTS & MEASURES
Functional Outcome Measures?
Reflect the impact of a patient’s pathological condition to and resulting impairments on functional abilities and health-related quality of life.
Measure patient’s perception of their disability due to impairment
process or a category.
essential element of patient management because it directs the physical therapy prognosis (including the plan of care) and interventions
DIAGNOSIS
T or F
Diagnosis in the physical therapy patient management model the same as the term clinical classification of diagnosis
FASLE
Diagnosis in the physical therapy patient management model is synonymous with the term clinical classification and is not to be confused with the term medical diagnosis.
the identification of a patient’s pathology or disease by its signs, symptoms, and data collected from tests ordered by the physician.
Medical Diganosis
T or F
Diagnosis established by a nurse is related to the primary dysfunction toward which the physical therapist directs treatment.
FASLE
Diagnosis established by a physical therapist is related to the primary dysfunction toward which the physical therapist directs treatment.
complex sequence of actions and decisions.
necessary to develop a prognosis (including a plan of care) and is a prerequisite for treatment.
DIAGNOSTIC PROCESS
T or F
in the diagnostic process, the PT’s Focus: consequences of a disease or health disorder
TRUE
grouping that identifies and describes patterns or clusters of physical findings
Whether it’s within our scope
DIAGNOSTIC CATEGORY
describes the impact of a condition on function at the system level and at the level of the whole person
DIAGNOSTIC CATEGORY
A set of observations or data that frequently occur as a group for a single patient.
Cluster
An aggregate of signs and symptoms that characterize a given disease or condition.
Syndrome
A label encompassing a cluster of signs and symptoms commonly associated with a disorder, syndrome, or category of impairment, activity limitation, or disability.
Diagnosis
Prediction of a patient’s optimal level of function expected as the result of a plan for treatment during an episode of care and the anticipated length of time needed to reach specified functional outcomes.
PROGNOSIS
BASIS FOR ESTABLISHING A PATIENT’S PROGNOSIS
Familiarity
Knowledge
Experience
Knowledge of the efficacy of tests and measures
T or F
“The plan of care is the culmination of the examination, diagnostic, and prognostic process.”
TRUE
Anticipated goals.
Expected functional outcomes that are meaningful, utilitarian, sustainable, and measurable.
PLAN OF CARE
Extent of improvement predicted and length of time necessary to reach that level.
PLAN OF CARE
Specific interventions.
Proposed frequency and duration of interventions.
Specific discharge plans.
PLAN OF CARE
T or F
Diagnosis should be directed at the elimination of the physical signs & symptoms & impairments.
FALSE
Goals & Outcomes should be directed at the elimination of the physical signs & symptoms & impairments.
T or F
Outcomes directed at eliminating functional deficits participation restrictions to the greatest extent possible
TRUE
BASES FOR PROGNOSES & PLAN OF CARE
The patient’s health status, risk factors, and response to previous interventions
The patient’s safety, needs, and goals
The natural history and the expected clinical course of the pathology, impairment, or diagnosis
The results of the examination, evaluation, and diagnostic processes
any purposeful interaction a therapist has that
directly relates to a patient’s care.
INTERVENTION
TYPES OF INTERVENTION
Direct intervention
Patient-related instruction
Coordination, communication, and documentation
What type of intervention are electronic medical record, patient care conferences
Coordination, communication, and documentation
What type of intervention are education provided to the patient and other caregivers involved regarding the patient’s condition, treatment plan, information and training in maintenance, and prevention activities
Patient-related instruction
What type of intervention are therapeutic exercise, manual therapy techniques, integumentary repair and protection techniques, motor function training
Direct intervention
Treat the “right” impairments.
Determine the impairment that most closely relates to an activity limitation or participation restriction.
CLINICAL DECISION-MAKING FOR INTERVENTION
The treatment of impairments can only lead to improvement in function if the impairments contribute directly to a limitation in activity.
CLINICAL DECISION-MAKING FOR INTERVENTION
A patient is discharged from physical therapy services when the anticipated goals and expected outcomes have been attained.
Includes the following:
✓ home program
DISCHARGE PLANNING
Results
Functional Outcomes
Measuring Outcomes
Patient Satisfaction
are componennts of?
OUTCOMES
An outcome is considered successful when the following conditions are met: (3)
Activity and participation is improved or maintained whenever possible.
Activity limitation or participation restriction is minimized or slowed when the status quo cannot be maintained.
The patient is satisfied.
If functional status has not improved when expected to, or declines when maintenance was the goal, consider modifying the intervention plan.
MODIFICATION
Modification of intervention is based on the status relative to the expected outcome and the rate of progress.
MODIFICATION
FACTORS TO CONSIDER WHEN
MODIFYING AN INTERVENTION
Medical safety
Patient comfort
Patient’s level of independence with the intervention
Effect of the intervention on the functional activities and participation restrictions
New or altered symptoms because of intervention by other health care providers
Patient finances, environment, and schedule constraints
