Bundling Services
OT, PT and ST should be an automatic order for any patient who comes to a facility. Some may disagree and talk about overutilization of therapy; however, when a need arises there is an unnecessary delay in services. If a patient comes with orders already written, then the therapist can decide whether services are indicated, not the admission clerk or nurse.
I have worked at some facilities where it can take several days for an order to come through for therapy services and valuable time is lost for the patient to succeed. One insurance company measured time in days, not therapy sessions, when a subscriber was admitted. When the "days" were up, the patient was discharged from the facility.
Any delay in obtaining orders would have a negative effect on the patient's outcome and performance. It also affects therapy because some will wonder what we did for the patient while that person was in the facility. Families are not concerned about obtaining orders; they want their loved one to get better. By having standing orders for therapy services with every admission, the therapists are able to get in and treat sooner with little or no delay.
This also places therapy more at the forefront of health care rather than an afterthought upon admission to a facility. If we can get primary providers to think more in terms of functional rehabilitation with patients and begin a brief discussion about therapy before we are involved in their care, the patients will more than likely be on board with the rehab process and may even take a more proactive role in getting back home.