Exploring Therapists’ Experiences Identifying Cognitive Impairments in Post-Acute Care

Abstract

Aims

Understanding therapy providers’ experiences with cognitive screening, assessment, and documentation can provide guidance on improving care quality.

Methods

Semi-structured interviews (n = 18) were conducted with therapy providers across disciplines and post-acute settings. Thematic analysis was used to identify themes.

Results

Six over-arching themes emerged pertaining to cognitive screening and assessment. (1) Therapists routinely conducted screening through task performance and informal observation. (2) Documentation habits varied due to multiple conflicting goals and lack of guidelines. (3) Therapists’ approach was honed on the job through clinical experience and trial and error. (4) Patient diagnosis, emerging medical conditions, and goals most strongly influenced therapists’ approach. (5) Roles and responsibilities were implicit. (6) The end goal was determining patient safety.

Conclusion

All therapy providers frequently screened for cognition, yet documentation varied widely. To increase consistent delivery and documentation of cognitive screening and assessment, future studies can examine strategies to streamline electronic health record platforms.

Keywords:

• Cognition
• health services research
• multiple case study design
• post-acute care

Disclosure statement

The work was supported by the School of Health and Rehabilitation Sciences PhD Award. The School of Health and Rehabilitation Sciences did not have a role in the design, methods, subject recruitment, data collections, analysis and preparation of paper. Outside of this award, authors have no conflicts of interest to disclose. All authors who significantly contributed are listed as authors in this section. Author roles are blinded for review.

Additional information

Funding

The work was supported by the School of Health and Rehabilitation Sciences PhD Award.

Notes on contributors

Stephanie A. Rouch

Stephanie Rouch provided substantial contributions to the study concept and design, acquisition of data, analysis and interpretation of data, drafting and critical review of the manuscript.

Elizabeth R. Skidmore

Elizabeth Skidmore provided substantial contributions to the study concept and design, acquisition of data, drafting and critical review of the manuscript.

Tana C. Pierro

Tana Pierro provided substantial contributions to the analysis and interpretation of data, drafting and critical review of the manuscript.

Kathryn R. Johnson

Kathryn Johnson provided substantial contributions to the analysis and interpretation of data, drafting and critical review of the manuscript.

Tina M. Harris

Tina Harris provided substantial contributions to the analysis and interpretation of data, drafting and critical review of the manuscript.

Alyssa N. Kelly

Alyssa Kelly provided substantial contributions to the analysis and interpretation of data, drafting and critical review of the manuscript.

Nancy Dubuar

Nancy Dubuar provided substantial contributions to the analysis and interpretation of data, drafting and critical review of the manuscript.

Natalie E. Leland

Natalie Leland provided substantial contributions to the study concept and design, acquisition of data, analysis and interpretation of data, drafting and critical review of the manuscript.