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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