Use of time by physiotherapists and occupational therapists in a stroke rehabilitation unit: A comparison between four European rehabilitation centres

Putman, Koen; Wit, Liesbet De; Schupp, W.; Baert, Ilse; Berman, Peter H.; Connell, Louise; Dejaeger, Eddy; Meyer, Anna Maria; Weerdt, Willy De; Feys, Hilde; Jenni, Walter; Lincoln, Nadina B.; Louckx, Freddy; Anneleen, Martens; Schuback, Birgit; Smith, Bozena; Leys, Mark

doi:10.1080/09638280600638216

Cited by 38 publications

(40 citation statements)

References 20 publications

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“…If therapists spent all their time in direct patient care the patient may have up to 39 hours of nursing care compared to 10 hours of PT, 9 hours of OT and 5 hours of SALT during their stay in an acute unit, for example. However, the percentage of time spent directly with patients is already reported as 46% for PT, 33% for OT [14] and 25% for SALT [15]. Therefore, the patient can expect up to 5, 3, and 2 hours respectively for each of the therapies PT, OT and SALT during their hospital stay.…”

Section: Resultsmentioning

confidence: 99%

“…Therefore, given 450 minutes per working day (7.5 working hours × 60 minutes), one therapist could provide the recommended amount of treatment to each of 10 patients if the therapist only treated patients. However, the percentage of time spent directly with patients is estimated at 46% for PT, 33% for OT [14] and 25% for SALT [15]. Table 6 sets out the number of therapy hours a patient may expect during their hospital stay.…”

Section: Resultsmentioning

confidence: 99%

“…To tease out how reasonable the ideal staffing figures were, particularly the OT figures, we calculated our own values based upon 1) the percentage of patients suitable for each of the three therapies taken from the National Sentinel Clinical Stroke Audit [1], and 2) the percentage of staff time spent in direct patient contact for PT, OT [14] and SALT [15]. These values are shown in Table 5, calculated in order to provide the NICE recommendation [11] of 45 minutes of each therapy to suitable patients per day over a 37.5 hours working week.…”

Section: Resultsmentioning

confidence: 99%

“…However, the literature suggests that only 46% of a physiotherapist's time is spent in direct patient care, thus a patient may expect less than 5 hours of physiotherapy during their stay in an acute unit. Likewise, the literature suggests 33% of OT time [14] and 25% of SALT time [15] is spent directly with patients. In an acute unit this provides less than 3 hours and 2 hours of OT and SALT time per hospital stay.…”

Section: Discussionmentioning

confidence: 99%

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A comparison between reported and ideal patient-to-therapist ratios for stroke rehabilitation

McHugh¹,

Swain²

2013

Health

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Objective: Major improvement has been made in the medical management of stroke in the UK between 2008 and 2010 based on the indicators measured in the National Sentinel Audit. However based on the same audit, no corresponding improvement has been effected to patient functional impairment levels on hospital discharge in the corresponding time frame. This study derived patient-to-therapist ratios as a means of exploring the amount of rehabilitation time for stroke patients while in hospital care. Method: A purpose specific survey was developed for completion by stroke teams. From a contact list compiled primarily in collaboration with the 28 National Stroke Improvement Networks, the N th name technique was used to target stroke teams in each geographical area covered by the 28 networks. Results: A total of 53 surveys were returned representing 20 of the 28 network areas providing 71% national coverage. Analysis conducted on 19 of the 37 inpatient hospital care units that were discrete units, had no missing data for staff numbers, unit bed numbers, number of stroke patients treated per annum, average unit length-of-stay, and unit occupancy rates. Staffing levels for some therapies were below the Department of Health staffing assumptions suggesting that stroke units are challenged to provide the recommended therapy time. Conclusions: Most stroke units surveyed are operating below the DH staffing assumption levels and are therefore challenged in providing the amount of therapy and patient time recommended in the National Institute of Clinical Excellence guidelines to facilitate optimal functional recovery for stroke patients.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A comparison between reported and ideal patient-to-therapist ratios for stroke rehabilitation

McHugh¹,

Swain²

2013

Health

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“…The content was similar in all 4 centers. In a third study, 20 we compared the activities of physical and occupational therapists. The proportion of time spent on direct patient care was the highest for the German physical (66.1%) and occupational therapists (63.3%) and lowest in the UK center, 45.9% and 32.9%, respectively.…”

Section: Discussionmentioning

confidence: 99%

Motor and Functional Recovery After Stroke

Wit

Putman

Schuback

et al. 2007

Stroke

Self Cite

113

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Background and Purpose— Outcome after first stroke varies significantly across Europe. This study was designed to compare motor and functional recovery after stroke between four European rehabilitation centers. Methods— Consecutive stroke patients (532 patients) were recruited. They were assessed on admission and at 2, 4, and 6 months after stroke with the Barthel Index, Rivermead Motor Assessment of Gross Function, Rivermead Motor Assessment of Leg/Trunk, Rivermead Motor Assessment of Arm, and Nottingham Extended Activities of Daily Living (except on admission). Data were analyzed using random effects ordinal logistic models adjusting for case-mix and multiple testing. Results— Patients in the UK center were more likely to stay in lower Rivermead Motor Assessment of Gross Function classes compared with patients in the German center (ΔOR, 2.4; 95% CI, 1.3 to 4.3). In the Swiss center, patients were less likely to stay in lower Nottingham Extended Activities of Daily Living classes compared with patients in the UK center (ΔOR, 0.7; 95% CI, 0.5 to 0.9). The latter were less likely to stay in lower Barthel Index classes compared with the patients in the German center (ΔOR, 0.6; 95%CI, 0.4 to 0.8). Recovery patterns of Rivermead Motor Assessment of Leg/Trunk and Rivermead Motor Assessment of Arm were not significantly different between centers. Conclusions— Gross motor and functional recovery were better in the German and Swiss centers compared with the UK center, respectively. Personal self-care recovery was better in the UK compared with the German center. Previous studies in the same centers indicated that German and Swiss patients received more therapy per day. This was not the result of more staff but of a more efficient use of human resources. This study indicates potential for improving rehabilitation outcomes in the UK and Belgian centers.

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Was Rehabilitation nach Schlaganfall für den Langzeitverlauf leisten kann

Schupp¹

2016

DNP

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Use of time by physiotherapists and occupational therapists in a stroke rehabilitation unit: A comparison between four European rehabilitation centres

Abstract: Time allocation differed between PT and OT and between units, affecting the time available for TA. Further investigation is necessary to study the effect of work organization in stroke rehabilitation units on the efficiency of rehabilitation regimes.

Cited by 38 publications

References 20 publications

A comparison between reported and ideal patient-to-therapist ratios for stroke rehabilitation

A comparison between reported and ideal patient-to-therapist ratios for stroke rehabilitation

Motor and Functional Recovery After Stroke

Was Rehabilitation nach Schlaganfall für den Langzeitverlauf leisten kann

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