Prioritizing care and time management Flashcards
How to determine which Pts you will see during each shift?
- Clinical judgement to prioritize Pt care to determine who would be seen
- Review the Pt list at the start of each shift and categorizing Pt care based on urgency
First triage Pt who will deteriorate /be in danger if not treated soon
E.g.
- Pt who need daily secretion clearance
- Stroke: dependent on PT for mobility
- Post-op: high risk for medical complications who requires an IA
- Fall risk Pt need mobility Ax & gaid aid
Next: Pt who will be DC shortly and dependent on a PT Ax
2nd: at risk of deteriorating without PT intervention. They require Rx but less urgent than those whom I deemed my first priority
E.g.
How to determine which Pts you will see during each shift? (Cont)
2nd: at risk of deteriorating without PT intervention. They require Rx but less urgent than those whom I deemed my first priority
E.g.
1. PROM daily to prevent contracture
2. Deconditioned need daily mobilization
3. Re-Ax after dec. mobility status
4. IA but not at risk of any respiratory/medical complications
5. DC nex week and require a PT Ax for DC planning
6. Joint session to delegate a task to a PTA for a Pt who no longer required direct PT intervention but requires daily intervention from a PTA to prevent decline
3nd: Pt will benefit from PT intervention, but the care is not urgent (will not deteriorate without it)
E.g.
1. Pt need Rx progression for Ex program
2. Joint session to delegate a task to a PTA for a Pt who no longer required direct PT intervention and could benefit from a PTA-assisted program to assist with the maintenance of their current function
Once I prioritize my Pt care, I would see Pts in the order listed above
* If I knew I was not going to have time to see all Pt with whom I deemed urgent , I would liaise with my team to see if a colleague on the ward could assess and/or treat them
Time management strategies
1. Arrive at work early
- extra time to plan and organize my day
2. Stay organized
- I could create a task schedule: morning task vs task that can be saved for later in the day
- Avoid multitasking & focus on one things
- Keep work area clean & tidy
- Plan to see Pt who are close together & save time walking back & forth
- Don’t spend too much time on one Pt and not enough time with others
3. Learn to say no
- If I truly do not have the time/resource to help
4. Avoid Assumption
- take my time to do sth need focus so I don’t waste time redoing it later due to an error
5. Delegate tasks to others
- Delegate tasks to the PTA so that more Pt can receive care
- Start to ask for help when I feel that I need it
Leaving a Practice
- Ask empolyer dun use my reg. no. for billing
- Plan for Pt who need ongoing care
- DC with HEP
- Transfer to Colleague or PT at a different clinic
–>ensure all PT records were up to date including nex steps forcare
–>transfer the record to next provider (consent) - Stop PTA service unless other PT can supervise
- Ensure personal liability insurance at my new job covers for any incident that could araise from working in public practice
- Notify the College of my job change within 30 days
Fracture ribs due to fall and struggle with bed mobility
VS mobilizing with a walker but new onset of LBP limit their ambulation distance.
Based on urgency
* prioritize seeing the Pt who I felt could deteriorate the greatest without Rx
Pt with rib fracture should be the priority
- Acute, unable mobilize in bed
- Lack of mobility could be deterimental to their overall well-being
- I may be able to provide some effective strategies to help improve bed mobility
Pt with new LBP
-They still should be seen by PT
- But they can independent mobilize with a walker thus less vulnerable to Physical deconditioning
Pt want to see private PT but still want to keep the session that is with me
Communicate with Pt
- They can see another PT
- Important for me to ensure I liaise with the other PT to ensure our Rx are complementary and do not conflict/overlap
Gain consent from Pt to communicate with the other PT
- Gain Pt consent to liasie the other PT
- Communicate with the other PT about the Pt’s Rx plan to ensure co-treating is in the Pt’s best interest
Make the decision
- After communication, If I felt that Pt would benefit from seeing 2 different practitioners, I would continue to treat.
- I woud ensure ongoing communication with the other PT
Virtual care: Pt moved to a new province
- I understand that I must be registered as a PT in the same province as the Pt I am treating. Because the Pt no longer live in the province that I am registered in, & I am not registered in the provide that they live in, I cannot treat them
- I would contact the Pt and let them know that I cannot provide PT services and why
- I would look up their new place of residence and provide them with a list of PT clinics near them.
Refer to Pt to OT service, Can you directly refer to another professional?
- Depends on how the referral process works for the treating health care practitioner.
**Fam Doc referral is required for specialist/3-rd party coverage of the service
E.g. Pt need a physiatry consult for Botox, they will need a referral from the Fam Doc.
PT: send that recommendation to the Fam Doc. so that the appropriate referral can be made
- I can recommend services that do not require a referral (RMT, OT, SW, SLP)
Provide Pt with a list of local OT
How does poor time management negatively impact Pt care?
- PT can’t see as many Pt in a day which leaves some Pts without care
- Spend less time delivering care
- Increase stress of PT and alter the ability to properly engage with Pts and learn what their Pt’s needs are
- PT in rush and can’t communicate with Pt to build strong therapeutic relationship
- Pt feel frustrated with waiting
How can poor time Mx
-ve impact personal wellness
- Dec. overall work enjoyment–>termination/resignation
- Career burnout–>less desire to continue to engage at work
- Less time/interest in pursuing continued education to improve the PT’s skills
Mental health effect
* Stress–>physical/mental health-related consequences
- Inc fatigue and irritability–> -ve impact social engagement
- Dec. in personal time (less time for hobbies/sports, socializing with frds/family)
Personal wellness practice to improve productivity
- Take a min to breathe, recharge & collect my thoughts: allow me to see clearly and focus on what needs to be done next
- Take all my meal break to refueal and recahrage
- Be patient with myself and reflect. Understand some things are beyong my control and should let them go. Focus on
- How can next time be better
- What did I do well today?
- What is working and not working?
*Be present–>improve my interactions with Pt and co-workers
- improve Pt outcome
- improve relationship with colleagues: inc. support & enjoyment at work.
