This analysis of the Veterans Health Administration root cause analysis database identified adverse events that occurred during rehabilitation services, such as physical therapy, occupational therapy, or speech and language therapy. Rehabilitation-related adverse events were extremely rare. The most common incidents were falls and delayed response to clinical deterioration.

This case study describes five cases of dizziness, each incorrectly diagnosed by a physician and subsequently correctly diagnosed by a physical therapist. The authors argue for involving allied health professionals in the diagnostic process, as recommended in the Improving Diagnosis report.

Transitions are a complicated and vulnerable time for patients, particularly for those with complex care needs. This review examines the literature around care transitions and insights from patient and family advisory councils. The authors recommend standardizing the process for veterans with complex conditions and suggest focus on the use of real-time information exchange, documented care plans, and engaging patients and their families in transitions.

This study sought to quantify adverse events associated with physical therapy and occupational therapy in the outpatient setting but was limited by incomplete record keeping.

The authors present six case studies of failures in occupational and physical therapy and analyze the ethical issues involved in each case.

The investigators surveyed patients regarding the coordination of their postdischarge care and identified problems with coordination across settings, within settings, and between patients and providers.