A Description of Weekend Physiotherapy Services in Three Tertiary Hospitals in the Greater Toronto Area

Hill, Kylie; Brooks, Dina

doi:10.3138/physio.62.2.155

Cited by 10 publications

(9 citation statements)

References 5 publications

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“…Less consistency in PT and OT staffing is reported to be associated with therapist difficulties with patient populations due to having limited or no expertise. 22–23 Distributing PT and OT staff with compatible expertise into clustered service areas (e.g., surgical ICU and surgical stepdown) may reduce variance in care as well as improve familiarity and interprofessional experiences amongst the different ICU providers. 22–23 …”

Section: Discussionmentioning

confidence: 99%

Organizational Domains and Variation in Attitudes of Intensive Care Providers Toward the ABCDE Bundle

Boehm¹,

Vasilevskis²,

Dietrich³

et al. 2017

Am J Crit Care

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Background The ABCDE interprofessional bundle (Awakening and Breathing Coordination, Delirium monitoring and management, and Early mobility) reduces delirium and weakness in critically ill patients, but bundle uptake is limited. Objective To understand the relationship between organizational domains and provider attitudes. Methods One-time electronic survey in ten ICUs across the country to examine associations between organizational domains of a) policy/protocol factors (protocol attributes, role clarity, training/understanding), b) unit milieu (coordination, peer advocates, teamwork), c) tasks (autonomy, time demands), d) labor quality (competence), e) labor quantity (sufficient staff), and f) physical environment (unit layout, supplies/equipment) with provider attitudes of a) perceived ease of completion, b) perceived safety, c) confidence, and d) perceived strength of evidence regarding the ABCDE bundle. Interprofessional participants must have worked ≥4 shifts/month (N=315). We used Spearman (rs) correlations to examine the associations between organizational domain and provider attitude subscales. Spearman ≥.32 was considered clinically significant. Results Protocol attributes (rs=0.37–0.58), role clarity (rs=0.38–0.59), training/understanding (rs=0.33–0.46), coordination (rs=0.32–0.46), and peer advocates (rs=0.37–0.48) were associated with less difficulty performing the bundle and better confidence, perceived safety and strength of evidence. Participants also reported less difficulty carrying out the bundle when the team works well together. Task autonomy was associated with better perceived safety (rs=0.35) and confidence (rs=0.47) related to the bundle. Conclusions There are organizational domains that positively influence provider attitudes. Policy and protocol factors, unit milieu, and task autonomy have the strongest associations with provider attitudes. Focusing interventions on these particular organizational domains may facilitate ABCDE bundle uptake.

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Section: Discussionmentioning

confidence: 99%

Organizational Domains and Variation in Attitudes of Intensive Care Providers Toward the ABCDE Bundle

Boehm¹,

Vasilevskis²,

Dietrich³

et al. 2017

Am J Crit Care

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“…14 Recently, a prospective workload assessment of physiotherapists working on weekends was conducted in three Toronto-area tertiary-care hospitals. 15 The authors found variation among these hospitals in terms of weekend and evening PT service delivery, the ability of physiotherapists working on weekends to share the workload, and the proportion of physical therapists completing unpaid overtime. This variation appeared to be related to the institutions' management structures (departmental vs. programme management).…”

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confidence: 99%

“…This variation appeared to be related to the institutions' management structures (departmental vs. programme management). 15 A survey of tertiarycare hospitals across Canada 16 found a 10% higher rate of provision of WPT than a survey of a broader range of hospital types performed a decade earlier. 14 Since earlier findings suggest that differences in access to weekend and evening service delivery are likely between academic and non-academic facilities, 13,14 investigations into facilities outside the tertiary setting should be conducted.…”

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confidence: 99%

Weekend Physiotherapy Practice in Community Hospitals in Canada

Ottensmeyer

Chattha

Jayawardena

et al. 2012

Physiotherapy Canada

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Purpose: To analyze weekend physiotherapy services in acute-care community hospitals across Canada. Method: Questionnaires were mailed to acutecare community hospitals (institutions with >100 inpatient beds, excluding psychiatric, mental health, paediatric, rehabilitation, tertiary, and long-term care facilities) across Canada from January to April 2010. The questionnaire collected information on patient referral criteria, staffing, workload, and compensation for weekend physiotherapy services and on the availability of other rehabilitation health professionals. Results: Of 146 community hospitals deemed eligible, 104 (71%) responded. Weekend physiotherapy was offered at 69% of hospitals across Canada, but this rate varied: b75% in all regions except Quebec (30%). Hospitals with a high proportion of acute-care beds were more likely to offer weekend physiotherapy services (logistic regression, p ¼ 0.021). Services differed among Saturdays, Sundays, and holidays in terms of the numbers of both physiotherapists and physiotherapy assistants working (Kruskal-Wallis, p < 0.02 for each). Physiotherapists were predominantly compensated via time off in lieu. Of hospitals not offering weekend physiotherapy, 53% reported that it would benefit patients; most perceived staffing and financial barriers. Social-work services were offered on the weekend at 24% of hospitals and occupational therapy at 16%. Conclusions: Substantial regional variation exists in access to weekend physiotherapy services in acute-care community hospitals. To address the importance of this variation, research on the efficacy and cost-effectiveness of such services is required.Key Words: rehabilitation; hospitals, community; delivery of health care; health services research. RÉ SUMÉObjectif : Analyser les services de physiothé rapie offerts durant les fins de semaine dans les hô pitaux communautaires de soins de courte duré e d'un bout à l'autre du Canada. Mé thode : De janvier à avril 2010, des questionnaires ont é té posté s aux hô pitaux communautaires de soins de courte duré e (é tablissements comptant plus de 100 lits pour hospitalisation, excluant les lits en psychiatrie, en santé mentale, en pé diatrie, en ré adaptation, les soins tertiaires et les é tablissements de soins prolongé s) partout au Canada. Le questionnaire visait à recueillir de l'information sur les critè res justifiant le renvoi en consultation, le personnel, la charge de travail et la ré muné ration pour des services de physiothé rapie offerts les fins de semaine, et sur la disponibilité d'autres professionnels de la santé oeuvrant en ré adaptation. Ré sultats : Des 146 hô pitaux communautaires admissibles, 104 (71 %) ont ré pondu. Des services de physiothé rapie é taient offerts les fins de semaine dans 69 % des hô pitaux au Canada, mais cette proportion varie : b75 % dans toutes les ré gions, sauf au Qué bec (30 %). Il é tait plus probable que des services de physiothé rapie soient offerts les fins de semaine dans les hô pitaux qui disposent d'une forte proportion de li...

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“…Patients requiring around-the-clock physiotherapy often, but not always, have acute or subacute respiratory conditions; 5 these can rapidly alter a patient's clinical status and often require intensive physiotherapy, necessitating several treatments per day and sometimes treatment at night. 8,9 The availability of 24/7 cardiorespiratory physiotherapy allows therapy to be started early, thereby avoiding the need to wait until the next morning or after the weekend and thus potentially improving patient care and outcomes.…”

Section: Discussionmentioning

confidence: 99%

Cardiorespiratory Physiotherapy around the Clock: Experience at a University Hospital

Devroey

Buyse

Norrenberg

et al. 2016

Physiotherapy Canada

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Purpose: To document and describe the use of a hospital-wide, 24-hour cardiorespiratory physiotherapy service run by an intensive care unit (ICU) team of physiotherapists. Methods: We prospectively collected data on all non-ICU hospital patients who used the 24-hours-per-day cardiorespiratory physiotherapy service over a 1-year period between July 2013 and June 2014. The ICU physiotherapists documented the reason, origin of referral, time of call, and type and frequency of treatment of each patient. Results: Over the 1-year period, the ICU physiotherapists administered 2,192 out-of-hours cardiorespiratory physiotherapy treatments (n=685 patients) outside the ICU. Most referrals originated from the emergency department (25%), the cardiopulmonary transplant unit (20%), and the pulmonology department (16%). Referrals were from a physiotherapist in 49% of cases, from a nurse in 32%, and from a physician in 19%. Of these, 89% were made between 4:00 p.m. and 8:00 a.m., and sputum retention was the most frequent reason (86%). Conclusion: Although proving its cost effectiveness is difficult, organizing a 24-hours-per-day, 7-days-per-week cardiorespiratory physiotherapy service in a large hospital is feasible.

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A Description of Weekend Physiotherapy Services in Three Tertiary Hospitals in the Greater Toronto Area

Cited by 10 publications

References 5 publications

Organizational Domains and Variation in Attitudes of Intensive Care Providers Toward the ABCDE Bundle

Organizational Domains and Variation in Attitudes of Intensive Care Providers Toward the ABCDE Bundle

Weekend Physiotherapy Practice in Community Hospitals in Canada

Cardiorespiratory Physiotherapy around the Clock: Experience at a University Hospital

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