Utilization of Physical Therapy in the Emergency Department: A Chance to Improve Care, Cost, and Outcomes

Introduction: Emergency departments are expected to be readily available to provide care to the public at any time, but on an average day, the ability to receive patients can be stretched to capacity, attempting to meet the demands for services. Within the United States, the most common cause for older adults to be seen and treated in the ED is due to falls. After experiencing a fall, roughly 35% of older adults were discharged from the ED with unrecognized but modifiable fall-risk factors. Provision of care from rehabilitation services at the right time and place has consistently presented challenges with barriers to access, including referral delays, scheduling delays, transportation, or additional costs. Ongoing staffing and labor pool shortages post-pandemic have further exacerbated the need for boarding of patients within the emergency department, resulting in avoidable complications such as delirium and hospital-acquired deconditioning that have shown worsening clinical outcomes for ill patients. Competing demands by providers and nursing staff in resource-constrained emergency departments make it necessary to task-shift provision of care to other services, including rehabilitation. Methods: Information was obtained by clinical practice and academic literature review via Google Scholar and the use of the University of Colorado library search. Results: Inclusion of a physical therapist within the emergency department has improved the opportunity for collaboration to reduce wait times for care and improved access to care. Patients and health systems have seen additional benefits with a reduction in costs associated with unnecessary hospital admissions, reduced use of narcotics for pain control, and a reduction in demands for imaging. The addition of regularly staffed PT in the ED allows for appropriate care by the appropriate provider in the emergency setting. Conclusion: Staffing a PT within the ED is safe, financially feasible, and well-received by physicians and nursing colleagues.