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PTA Blog Talk

Bundling Services

Published March 9, 2011 6:32 PM by Jason Marketti

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.

3 comments

Becky,

I appreciate the comment and Its nice to know I am not the only PTA out there breaking ground as a DOR who still has a caseload.

Jason Marketti March 21, 2011 9:41 AM

Jason,

Thank you for your article in Advance dated March 7.  I have been a PTA for 13.5 years and a DOR for 11 of those.  I came into a small hospital in a rural setting with a LTC facility attached with a PT 1/2 to 3/4 of a day and a full time PTA (myself.)  We have grown to one full time PT, one full time PTA (myself) and a full time OT with SLP PRN.  The demands can be daunting but I love a good challenge.  Not only do I serve as DOR but I also carry an almost full caseload daily.

Becky, PTA March 15, 2011 2:06 PM
Lakeland GA

I've worked in situations where the standing orders were for: OT, PT, and SLP evaluation. This works, as the patient benefits from a comprehensive analysis and each discipline can decide if their service is needed or not. I've also had some therapists complain they waste too much time on unnecessary assessments that way. I think that is wrong...we, nor should other disciplines, rely upon others to decide if we are "necessary". That automatically says that nursing or doctors can determine our value and gives up our autonomy.

So standing treatment orders, I don't agree. Standing assessment orders, I'm on board.

Dean Metz March 9, 2011 3:37 PM

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    Jason J. Marketti
    Occupation: Physical Therapist Assistant
    Setting: San Jacinto, CA
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