Quality of Care Indicators for Hospital Physical Therapy Units: A Systematic Review

Abstract

Objective The purpose of this review was to identify quality indicators described in the literature that may be used as quality measures in hospital physical therapy units. Methods The following sources were searched for quality indicators or articles: Web of Science, MEDLINE, IBECS, Latin American & Caribbean Health Sciences Literature, Cumulative Index of Nursing and Allied Health, Academic Search Complete, SportDiscus, SciELO, PsychINFO, Consejo Superior de Investigaciones Cientificas, and Scopus databases; the Agency for Healthcare Research and Quality, National Health System Indicator Portal, Joint Commission on Accreditation of Healthcare Organizations, and Organisation for Economic Co-operation and Development websites; and the National Quality Forum’s measures inventory tool. Search terms included “quality indicator,” “quality measure,” “physiotherapy,” and “physical therapy.” Inclusion criteria were articles aimed at measuring the quality of care in hospital physical therapy units written in English, Spanish, French, or Portuguese. Evidence-based indicators with an explicit formula were extracted by 2 independent reviewers and then classified using the structure-process-outcome model, quality domain, and categories defined by a consensus method. Results Of the 176 articles identified, only 19 met the criteria. From these articles and from the indicator repository searches, 178 clinical care indicators were included in the qualitative synthesis and presented in this paper. Process and outcome measures were prevalent, and 5 out of the 6 quality domains were represented. No efficiency measures were identified. Moreover, structure indicators, equity and accessibility indicators, and indicators in the cardiovascular and circulatory, mental health, pediatrics, and intensive care categories were underrepresented. Conclusions A broad selection of quality indicators was identified from international resources, which can be used to measure the quality of physical therapy care in hospital units. Impact This review identified 178 quality-of-care indicators that can be used in clinical practice monitoring and quality improvement of hospital physical therapy units. The results highlight a lack of accessibility, equity, and efficiency measures for physical therapy units.

Quality aspects of hospital-based physiotherapy from the perspective of key stakeholders: a qualitative study

“…A recent systematic review of quality of care indicators for hospital-based physiotherapy emphasises once more that in this field more research is necessary to provide proven, evidencebased quality measures to fill this gap and determine how indicators can be implemented in everyday practice. 14 However, part of our findings touches on the conclusion of earlier research into the changing role of the physical therapist in hospitals: an increased emphasis on higherlevel skills in patient care and professional interaction and the continuing importance of professionalism. 15 16 In general, information from a stakeholder analysis can be used to develop strategies for managing these stakeholders, to facilitate the implementation of specific decisions or organisational objectives or to understand the policy context and assess the feasibility of future policy directions.…”