Patient and list Management

This is a topic that was never discussed while at university or from other clinics. It is to provide guidelines on how to develop and maintain a patient list. The goal is to let this occur naturally by rebooking and planning patient rehab appropriatly, while maintaining our ethics and not booking patients just to hit a set number.

Guidelines

Acute Patients: These are pains in ALOT of pain or who have just sustained an injury or a flare up of an old injury/acute on chronic. These patients we know hands on treatments is going to be most using for Pain modulation, ongoing assessment, swelling management and referral for imaging if required. A higher frequency is recommended to speed along this early stage. Aim for two or three times per week for the first two weeks. Explain to the patient why we rebook this way and that the effectiveness of it rather than waiting a fortnight and letting the patient remain in pain for longer. The added benefit of educating and reassuring the patient frequently helps enormously in this stage.

Subacute: If we go by text book definition subacute is anything past the acute stage to three months. Obviously this is a huge range. During this period patients should have some form of home exercise program and be able to function at a greater level in ADLs. Pain should have also decreased by small to moderate amount also. At this stage our hands on methods are still effective but the rehab based exercises have just as much importance. Aim to rebook once per week for one to four weeks. Do so based on the current patient presentation.

Chronic: Three months post, once again this is text book definition. If rehab is going well pain should be fairly low on the NPS, function improving and HEP transitioning to more generalised strength training program while still emphasising the previous injury or condition. Hands on should be kept to a minimum unless small flare ups have occurred. Unless the patient requires more supervised sessions they can be weened to once per fortnight to three weeks. This can be continued until the patient hits their goals and the exit criteria as follows. It is important to remind the patient they are in the end stage of rehab to keep motivation high.