Basic Concepts on the Management of a Physical Therapy Service Organization

PTs can also be clinical specialists…

Specialty Areas–Cardiovascular and Pulmonary Physical

Therapy–Clinical Electrophysiology–Geriatric Physical Therapy–Neurologic Physical Therapy–Orthopedic Physical Therapy–Pediatric Physical Therapy–Sports Physical Therapy

Practice Settings

Physical therapists practice in a broad range of inpatient, outpatient, and community-based settings, including the following:–Hospitals (critical care, intensive care, acute

care, and sub-acute care)–Outpatient clinics or offices–Rehabilitation facilities

–Skilled nursing, extended care, or sub-acute facilities

–Homes–Education or research centers–Schools and playgrounds (preschool,

primary, and secondary)–Hospices–Corporate or industrial health centers

– Industrial, workplace, or other occupational environments

–Athletic facilities (collegiate, amateur, and professional)

–Fitness centers and sports training facilities

Patients and Clients

Patients– Individuals who are the recipients of

physical therapy examination, evaluation, diagnosis, prognosis, and intervention and who have a disease, disorder, condition, impairment, functional limitation, or disability

Clients– Individuals or organizations (e.g. businesses,

school systems, athletic teams) who engage the services of a physical therapist and who can benefit from the physical therapist’s consultation, interventions, professional advice, prevention services, or services promoting health, wellness and fitness

Generally accepted elements of patient/client management typically apply to both patients and clients

Scope of Practice

Physical Therapy–The care and services provided by or

under the direction and supervision of a physical therapist

Physical Therapists (PTs)–The only professionals who provide

physical therapy

Specifically:– Provide services to patients/clients who have

impairments, functional limitations, disabilities or changes in physical function and health status resulting from injury, disease, or other causes

– Interact and practice in collaboration with a variety of professionals

– Address risk

–Provide prevention and promote health, wellness, and fitness

–Consult, educate, engage in critical inquiry, and administrate

–Direct and supervise the physical therapy service, including support personnel

The Physical Therapy Service: Direction and Supervision of Personnel

Direction and supervision are essential to the provision of high-quality physical therapy

The degree of direction and supervision necessary for ensuring high-quality physical therapy depends on many factors, including:– Education, experience, and responsibilities of the

parties involved– Organizational structure in which the physical

therapy is provided– Applicable state law

In any case, supervision should be readily available to the individual being supervised

Director of the Physical Therapist Service–A physical therapist who has

demonstrated qualifications based on clinical education and experience in the field of physical therapy and who has accepted the inherent responsibilities of the role

Director of the Physical Therapist Service–Responsibilities of the director of the

physical therapy service:• Establish guidelines and procedures that will

delineate the functions and responsibilities of all levels of physical therapy personnel in the service and the supervisory relationships inherent to the functions of the service and the organization

Director of the Physical Therapist Service

• Ensure that the objectives of the service are efficiently and effectively achieved within the framework of the stated purpose of the organization and in accordance with safe physical therapist practice

• Interpret administrative policies

Director of the Physical Therapist Service

• Act as liaison between line staff and administration

• Foster the professional growth of the staff

Director of the Physical Therapist Service–Also has responsibilities borne solely by

physical therapists

Physical Therapist–When the physical therapist directs

assistive personnel to perform specific components of physical therapy interventions, that physical therapist remains responsible for supervision of the plan of care

Physical Therapist–Regardless of the setting in which the

service is given, the following responsibilities must be borne solely by a physical therapist:• Interpretation of referrals when available• Initial examination, evaluation, diagnosis,

and prognosis

Physical Therapist• Development or modification of a plan of

care that is based on the initial examination or the re-examination and that includes physical therapy anticipated goals and expected outcomes

Physical Therapist• Determination of:

– When the expertise and decision-making capability of the physical therapist requires the physical therapist to personally render physical therapy interventions and

– When it may be appropriate to utilize the physical therapist assistant

Physical Therapist• Provision of physical therapy interventions• Re-examination of the patient/client in light

of the anticipated goals and expected outcomes, and revision of the plan of care when indicated

• Establishment of the discharge plan and documentation of discharge summary/status

• Oversight of all documentation for services rendered to each patient

Assistive Personnel–Person(s) who may assist the physical

therapist either in selected components of intervention or some other aspect of the overall care of a patient• Physical Therapist Assistants (PTAs)• Physical Therapy Aides (PT Aides)

Other Assistive Personnel–Persons licensed or certified in another

discipline but who are employees in a physical therapy service under the supervision of a physical therapist• massage therapists• exercise physiologists• athletic trainers

Support Personnel–Not involved directly in patient care

• Management• Clerical• Maintenance