Last updated
Inpatient on Unit Physical Therapy Gym
Share PrintThe on-unit physical therapy gym was implemented to encourage early ambulation and engage post operative patients early in their recovery. The location of the space allowed therapist the ability to work with patients throughout the day without transport and scheduling to the physical therapy department on the opposite side of the facility. This decreased nurse time off the unit for transport and increased patient satisfaction.
Origin:
June 2021, Charles George Department of Veterans Affairs Medical Center (Asheville)
Adoptions:
1 successful
Recent Updates
Overview
Problem
Physical Therapy (PT) is a vital part of recovery following surgery. It improves flexibility, range of motion, and aides in the healing process. During the pandemic, obtaining PT services was challenging as leaving the unit was restricted for safety precautions. This resulted in delayed PT care for Veterans, and contributed to extended length of hospital sta
...
Physical Therapy (PT) is a vital part of recovery following surgery. It improves flexibility, range of motion, and aides in the healing process. During the pandemic, obtaining PT services was challenging as leaving the unit was restricted for safety precautions. This resulted in delayed PT care for Veterans, and contributed to extended length of hospital stays. Nurse time off the unit to transport and monitor patients decreased the time nurses spent caring for other patients.
See
more
- The graph depicts the time staff is off the unit to transport patients to physical therapy. Staff time of unit
Files
Solution
In collaboration with the physical therapy department, a two person patient room was converted to an on-unit physical therapy gym. The physical therapy supervisor assigned staff to the gym as their daily assignment, this increase the time and frequency of therapy provided to post-operative patients.
- Photo of patient room conversion to physical therapy gym. On unit PT gym image
Files
Results
This project focused on reducing the nursing staff time needed to transport Veterans to Physical Therapy. Pre improvement a minimum of 5 staff/day were transporting Veterans and spending an average of 45 minutes/transportation. This totals to 900 hours/year of staff time to transport Veterans to PT. Following the process improvement no nursing staff were ne
...
This project focused on reducing the nursing staff time needed to transport Veterans to Physical Therapy. Pre improvement a minimum of 5 staff/day were transporting Veterans and spending an average of 45 minutes/transportation. This totals to 900 hours/year of staff time to transport Veterans to PT. Following the process improvement no nursing staff were needed for Veteran transportation to PT resulting in a 100% cost savings and time saved. The intangibles to this project also include the reduction of workload for those staff who remained on the unit while the other staff were off-unit with the Veteran.
During the COVID 19 pandemic when short term rehabilitation (STR) facilities were not accepting patients due to COIVD exposure, the on-unit physical therapy gym allowed patient to continue therapy and continue their post operative recovery. In some cases, the patients were able to return home instead of requiring a STR stay. Patient satisfaction increased with the ability of patients to participate in therapy twice daily and caregivers to participate in instruction. See more
During the COVID 19 pandemic when short term rehabilitation (STR) facilities were not accepting patients due to COIVD exposure, the on-unit physical therapy gym allowed patient to continue therapy and continue their post operative recovery. In some cases, the patients were able to return home instead of requiring a STR stay. Patient satisfaction increased with the ability of patients to participate in therapy twice daily and caregivers to participate in instruction. See more
- Return on investment of saved staff costs after implementation. ROI of implementation
Files
Metrics
- Number of staff hours saved annually, 900 hours
- Total labor cost savings, $190,755
Diffusion tracker
Does not include Clinical Resource Hubs (CRH)
Implementation
Timeline
-
1 week
Gathered data to support process improvement. The data gathered included length of stay, historical and current average daily census, time capture of staff off unit for transport. Collaborated with physical therapy chief to determine needs and feasibility. Data collected was used to create presentation for leadership team. -
1-3 days
Presented to leadership team for approval. -
1 week
Removed furniture from patient room and found storage for possible future need. Determined equipment to purchase and placed equipment. -
1-3 weeks
Waiting on equipment to arrive for installation. Some equipment was borrowed from physical therapy until permanent equipment arrived. This allowed for the opening of the gym.
Departments
- Housekeeping
- Nursing services
- Occupational health and safety
- Orthopedics
- Rehabilitation and prosthetics
- Surgery
Core Resources
| Resource type | Resource description |
|---|---|
PEOPLE |
|
TOOLS |
|
Risks and mitigations
| Risk | Mitigation |
|---|---|
| Loss of patient beds could decreased flow or cause diversion | The room was designed for a 24 hour or less conversion back to a patient room. The patient furniture was stored for possible conversion. |
About
Origin story
The on-unit physical therapy gym was a long term plan to compliment our Enhanced Recovery After Surgery (ERAS) program to promote early mobility. When COVID-19 peaked, there was an apparent need for post surgical patients to continue physical therapy. The problem occurred when inpatients were unable to go to the physical therapy department due to possible o
...
The on-unit physical therapy gym was a long term plan to compliment our Enhanced Recovery After Surgery (ERAS) program to promote early mobility. When COVID-19 peaked, there was an apparent need for post surgical patients to continue physical therapy. The problem occurred when inpatients were unable to go to the physical therapy department due to possible outpatient exposure. The inpatient areas were also facing extended lengths of stay due to short term rehab facilities not accepting patients due to COVID -19 outbreaks. The inpatient nurse leadership met with physical therapy leadership to consider a solution. The on-unit PT gym was suggested and implemented. The gym allowed for patients to continue therapy and at times increased frequency of therapy sessions. Staff were no longer pulled off the unit to transport patients to therapy. As the pandemic was ending, visitation was again granted and caregivers participated in the therapy sessions with the Veterans. The implementation proved successful and has become a part of the ERAS program.
Original team
Amanda Graves
Nurse Manger, inpatient surgical
Josh Walbert
Physical therapy supervisor
Tamara Cornell
Physical therapy supervisor
Comment
Comments and replies are disabled for retired innovations and non-VA users.