Exploring the role of patient activity in the clinical decision-making processes of health care practitioners working in hospital care: A qualitative study.
Carlos de Miguel Llorente, Miriam Van Der Velde, Ireen Scheffers and 2 others
PMID 41223070WHAT IT FOUND
Practitioners rely on intuition and subjective impressions of patient activity rather than objective measures when making decisions about discharge, medication, and mobility aids.
This lack of standardized assessment creates inconsistent communication across wards and complicates shared decision-making.
Key findings
01Clinical decisions regarding discharge, medication, walking aids, and surgical eligibility were influenced by patient activity, but these judgments relied on intuition and experience rather than explicit numerical thresholds or standardized guidelines.
02The absence of objective measurements and shared terminology for patient activity led to inconsistent recording across wards and hindered effective multidisciplinary communication.
03Nurses and physiotherapists were valued sources of information on patient activity during multidisciplinary meetings, but unclear professional boundaries regarding who was responsible for assessing and reporting activity acted as a barrier to timely decision-making.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was conducted in a single hospital in the Netherlands, which may limit the transferability of findings to other healthcare settings or cultures. Most interviews were conducted in English by a researcher whose native language was Spanish, with participants whose native language was Dutch, although high English proficiency in the region was noted. The study did not include occupational therapists or social workers, who also play roles in patient care and activity, potentially missing perspectives on interdisciplinary decision-making. An observer effect may have influenced behavior during the naturalistic observations, as participants knew they were being watched.
Declared interests
The authors declared no potential conflicts of interest and received no financial support for the research.
The easy way to misread this
Do not interpret the reliance on intuition and subjective assessment as a failure of professional judgment or a lack of competence. The study identifies these as systemic issues stemming from a lack of standardized tools and shared language across wards, rather than individual practitioner error.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →