Physiotherapy Models of Service Delivery, Staffing, and Caseloads: A Profile of Level I Trauma Centres across Canada

Abstract

Purpose: To examine and describe physiotherapy models of service delivery, staffing, and caseloads in Level I trauma centres across Canada. Methods: A telephone questionnaire was administered to one experienced trauma physiotherapist at each of the 19 Level I trauma centres in Canada. Quantitative data were analyzed descriptively for national trends. Results: Data were collected from all 19 centres (100%), 89% of which provided physiotherapy services 5 days per week with priority weekend coverage. Physiotherapist assistants (PTAs) were employed by 89% of centres and were used across the continuum of care. Centres with PTAs appear to be more likely to provide patients with additional daily treatment. Departmental organizational structures were the most common (41%) and were associated with higher caseloads. Higher caseloads also appear to be linked with having less than 10 years of experience as a physiotherapist. Conclusions: Variations exist between centres with respect to the delivery of physiotherapy services. These variations may result from differences in province-specific legislation, differences in funding structure, and the lack of evidence-informed guidelines. Future research is needed to establish optimal models of physiotherapy services that are cost-effective and provide best patient care.Key Words: trauma center; physical therapy department, hospital; personnel staffing and scheduling. RÉ SUMÉObjectif : É tudier et dé crire les modè les de prestation de services, de dotation et de charge de travail de la physiothé rapie dans les centres de traumatologie de niveau 1 au Canada. Mé thodologie : Un questionnaire té lé phonique a é té envoyé à un physiothé rapeute d'expé rience de chacun des 19 centres de traumatologie de niveau 1 au Canada. Des donné es quantitatives ont fait l'objet d'une analyse descriptive afin de dé gager des tendances nationales. Ré sultats : Des donné es ont é té recueillies dans les 19 centres (100 %). De ce nombre, 89 % assuraient des services de physiothé rapie cinq jours par semaine, avec couverture prioritaire les fins de semaine. Des assistants-physiothé rapeutes (APT) sont employé s dans 89 % des centres et sont mis à contribution dans tout le continuum de soins. Ces centres qui disposent d'APT semblaient davantage en mesure de prodiguer aux patients des soins quotidiens supplé mentaires. Les structures organisationnelles de type dé partemental sont les plus habituelles (41 %) et ont é té associé es à des charges de travail plus é levé es. Une charge de travail plus é levé e semble é galement ê tre lié e à une expé rience professionnelle de moins de 10 ans comme physiothé rapeute. Conclusions : La prestation de services de physiothé rapie varie selon les centres. Ces variations peuvent s'expliquer par des diffé rences dans les lois propres à chaque province, par la structure de financement de ces centres, ainsi que par le manque de guides de pratique fondé s sur les faits probants. De futures é tudes seront né cessaires pour é tablir des modè les optimaux de services de phys...

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