Case Management

Process of referring a patient for a physiotherapy assessment from case management.

The process of getting a patient assessed by a physiotherapist, starting from the case manager contacting the physiotherapy manager, involves a series of steps to ensure the patient receives the appropriate care. Below is a step-by-step breakdown of this process:

1. Case Manager Contacts Physiotherapy Manager

Initial Referral: The case manager identifies the need for physiotherapy based on the patient’s condition or concerns (e.g., mobility issues, neurological conditions, musculoskeletal problems).

Information Gathering: The case manager provides relevant information to the physiotherapy manager, including:

• Patient’s medical history
• Reason for referral (e.g., diagnosis, symptoms)
• Specific areas where physiotherapy is required
• Any urgent concerns or special needs (e.g., communication difficulties, cognitive impairments)

Discussion of Availability: The case manager checks the availability of physiotherapists with the required specialty or expertise for the patient’s needs.

2. Physiotherapy Manager Reviews the Case

Assess Needs: The physiotherapy manager reviews the referral information and determines the appropriate physiotherapist(s) to assess the patient.

Check Physiotherapist Availability: They confirm which physiotherapist has availability to assess the patient and expertise in handling the condition.

Approval: Once the physiotherapy manager confirms the necessary resources (qualified physiotherapist, available time), they provide the case manager with costings for the requested assessment, and subsequent report. Following this, the physiotherapy manager awaits the approval of the case manager to proceed with the next steps.

3. Coordination of Initial Assessment Appointment

Scheduling the Appointment: The physiotherapy manager schedules an assessment appointment based on the patient’s availability and the physiotherapist’s schedule.

Informing the Patient: The physiotherapy team contacts the patient to inform them of the assessment appointment, confirming the time, location, and any instructions (e.g., what to bring, how to prepare).

4. Physiotherapist Prepares for Assessment

Review Patient’s History: The physiotherapist reviews the referral information provided by the case manager to understand the patient’s medical history, diagnosis, and specific concerns.

Prepare Tools/Equipment: If necessary, the physiotherapist ensures they have the appropriate equipment or tools needed for the assessment (e.g., balance testing tools, mobility aids, etc.).

5. Patient Assessment by Physiotherapist

Introduction and Rapport Building: Upon meeting the patient, the physiotherapist introduces themselves and explains the purpose of the assessment, establishing trust and comfort.

Medical History Review: The physiotherapist goes through the patient’s medical history in detail, discussing the symptoms, any previous treatments, and lifestyle factors that may affect treatment.

Physical Examination: The physiotherapist conducts a physical assessment to evaluate:

• Range of motion
• Strength
• Posture
• Gait and balance (for neurological or musculoskeletal conditions)
• Neurological tests (if applicable)

Functional Assessment: The physiotherapist may assess the patient’s ability to perform daily activities (e.g., walking, sitting, standing, transferring).

Pain Assessment: If applicable, the physiotherapist may assess pain levels, triggers, and relief methods.

Setting Treatment Goals: Based on the findings, the physiotherapist works with the patient to set realistic and achievable treatment goals.

6. Physiotherapist Develops a Treatment Plan

Personalised Treatment Plan: After the assessment, the physiotherapist develops an individualized treatment plan based on the findings, which may include:

• Exercise prescriptions
• Manual therapy techniques
• Assistive devices recommendations
• Education on posture and movement
• Referrals to other specialists if needed

7. Case Manager Receives Assessment Report

Report Preparation: The physiotherapist prepares a detailed assessment report, which includes:

• Patient's history and current condition
• Findings from the physical and functional assessments
• Proposed treatment plan
• Expected outcomes and goals

Sharing the Report: The report is shared with the case manager.

8. Follow-Up and Monitoring

Coordination for Ongoing Care: If the physiotherapy recommendations are authorised, the case manager coordinates with the physiotherapy team to schedule follow-up appointments based on the physiotherapist’s recommendations.

Progress Updates: The physiotherapist provides periodic progress reports to the case manager, allowing for ongoing adjustments to the treatment plan if needed.

Communication with the Client: The case manager may check in with the patient regularly to ensure they are progressing and to address any concerns about the physiotherapy treatment.

9. Review and Adjust Treatment Plan as Needed

Ongoing Assessments: The physiotherapist continues to monitor the patient’s progress, making adjustments to the treatment plan based on the patient’s response to therapy.

Collaboration: The case manager may be involved in the process of adjusting the treatment plan if there are changes in the patient’s health status or goals.

10. Discharge or Transition of Care

Discharge Planning: Once the patient achieves their goals or is ready for discharge, the physiotherapist, case manager, and other healthcare professionals involved in the care plan discuss the next steps, which may include:

• A home exercise program
• Transitioning to independent management
• Referrals for further care (e.g., another type of specialist or therapy)

Final Report: The physiotherapist provides a final report summarizing the progress, outcomes, and recommendations for the patient’s continued care.

Throughout this process, communication between the case manager, physiotherapist, patient, and other healthcare professionals is critical for ensuring the patient receives the most appropriate and effective care.