PERCEPTIONS OF ACUTE-CARE PHYSICAL THERAPY PRACTICE - ISSUES FOR PHYSICAL THERAPIST PREPARATION

Background and Purpose. Acute care physical therapists have experience d the effects of dramatic changes in health care reimbursement systems and population demographics Acute care hospitals now serve a patient population of much older, chronically ill patients who are hospitalize d for shorter periods of time in a practice environment in which physi cal therapy staffing resources are often inadequate. The purposes of t his study were to document common experiences in the practice of acute care physical therapy and to identify differences in the perceptions of physical therapists with varying levels of experience and in variou s sizes of acute care facilities. Subjects and Methods. A survey quest ionnaire was mailed to 500 randomly selected physical therapists emplo yed in acute care facilities The therapists answered questions regardi ng the frequency of various physical therapy evaluation and treatment practices, problems encountered in delivering physical therapy service s, coordination of the discharge planning process, and perceptions of staffing trends in the acute care setting The responses of 188 physica l therapists who completed the survey were compared by their experienc e levels and the size of the institutions in which they practiced. Res ults. Subjects reported that patient factors, such as medical complica tions and cooperation, organizations factors, such as staffing shortag es and large caseloads, and health care system constraints, such as di fficulty changing orders and limited time in which to work with the pa tient interfered with patients reaching physical therapy goals. Conclu sion and Discussion. Inadequate skills for successful acute care pract ice and maladaptive therapist beliefs about acute care career possibil ities may adversely affect physical therapist career longevity in the acute care setting.