PT9: Organization and Administration in Physical Therapy (Notes and Presentations)

1. Basic Concepts on the Management
of a Physical Therapy Service
Organization

2. 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

3. 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

4. – 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

5. – Industrial, workplace, or other occupational
environments
– Athletic facilities (collegiate, amateur, and
professional)
– Fitness centers and sports training facilities

6. 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

7. 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

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

9. 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

10. 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

11. – 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

12. The Physical Therapy Service:
Direction and Supervision of
Personnel
Direction and supervision are
essential to the provision of high-
quality physical therapy

13. 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

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

15. 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

16. 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

17. 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

18. Director of the Physical Therapist
Service
• Act as liaison between line staff and
administration
• Foster the professional growth of the staff

19. Director of the Physical Therapist
Service
– Also has responsibilities borne solely by
physical therapists

20. 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

21. 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

22. 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

23. 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

24. 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

25. 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)

26. 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

27. Support Personnel
– Not involved directly in patient care
• Management
• Clerical
• Maintenance