Physio Referral (Inpatient) 🏃
Guide for inpatient physiotherapy referral. Key information to provide, common indications (mobility, respiratory, falls, discharge planning), and referral scripts for NCHDs.
📋 Key Info to Have Ready
- Patient identifiers: name, DOB, MRN, ward and bed location
- Reason for referral, being specific: mobility assessment, respiratory physio, falls review, or discharge planning
- Baseline mobility: independent, stick, rollator, hoist, or bedbound; and mobility now compared to baseline
- Weight-bearing status if post-op or post-fracture (e.g. full weight-bearing, partial, non-weight-bearing); confirm with the surgical team
- Medical stability: is the patient safe to mobilise? Any restrictions (e.g. spinal precautions, unstable fractures, active bleeding)?
- Attachments: oxygen, IV lines, catheter, drains, telemetry (these affect what physio can do)
- Cognition: delirium, dementia, ability to follow instructions
- Falls history during this admission or at home
- Home setup and social situation: stairs, lives alone, existing home care or aids
- Anticipated discharge plan and timeframe, as physio input often determines discharge readiness
🔎 Common Reasons to Refer
- Mobility assessment and rehab after acute illness or deconditioning
- Post-operative mobilisation (especially orthopaedic and abdominal surgery)
- Respiratory physio: sputum retention, atelectasis, pneumonia, COPD exacerbation, post-op chest complications
- Inpatient fall or high falls risk: gait and balance assessment
- Assessment for mobility aids (stick, frame, rollator) before discharge
- Discharge planning: stairs assessment, mobility sign-off, onward rehab or home physio referral
- Neurological rehab: stroke, Parkinson's disease, neuropathy affecting mobility
📞 Example Referral
- Hi, this is [Your Name], the intern from [Team Name]. I'd like to refer a [Age]-year-old patient on [Ward] for physiotherapy.
- They were admitted with [reason for admission] and are now medically [stable/improving]. We're referring for [e.g. mobility assessment / chest physio / falls review / discharge planning].
- Their baseline is [e.g. independent with a stick] but they're currently [e.g. requiring assistance of two to transfer]. They are [full/partial/non-]weight-bearing.
- They have [attachments, e.g. oxygen at 2L, IV fluids] and their cognition is [intact/impaired]. The plan is for discharge [home/to rehab] once mobility is back to baseline.
- Many hospitals use an electronic or paper referral form rather than a phone call. Include the same details there, and phone the physio department directly if the referral is urgent (e.g. respiratory).
📝 Tips
- Refer early: physio input is often the rate-limiting step for discharge, so don't wait until the patient is 'medically fit'
- Always document weight-bearing status in the referral for post-op and fracture patients, as physio cannot mobilise without it
- Specify chest physio clearly and flag urgency, since out-of-hours and weekend physio cover is usually limited to urgent respiratory cases
- Ward staff can mobilise stable patients, so reserve referrals for patients who need assessment, rehab, or aids
- If the patient declines or is too drowsy/unwell to participate, address that first and let physio know, as repeated failed reviews delay everyone
- For complex discharges, raise the patient at the MDT meeting so physio, OT, and social work are aligned