Acute Care Physical Therapy Practice Analysis Identifies the Need for a Core Outcome Measurement Set

Abstract

Purpose: This study's primary objective is to determine the current use of outcome measures (OMs) by physical therapists practicing in acute care settings. Secondarily, this study aims to establish whether physical therapists support the development of a core OM set for use in acute care settings. Methods: An investigator-developed online survey (Qualtrics) was distributed to acute care physical therapy stakeholders, including practicing clinicians, educators, and administrators. The survey contained 4 sections with 28 questions: (1) acute care physical therapy practice patterns; (2) use of OMs in practice; (3) the development of a core OM set; and (4) demographic, education, and experience in the physical therapy profession. Descriptive statistics were used to assess response frequency and rationale for the use of specific OMs. Results: A convenience sample of 170 acute physical therapy stakeholders completed the survey. Respondents represented 38 states, with most respondents (n = 153; 90%) practicing in one or more acute care specialty areas. The majority of respondents (n = 145; 83%) reported using an OM more than 50% of the time in their practice. Physical function was the main construct (n = 163; 96%) respondents assessed with an OM. Acute care physical therapists primarily used OMs to track response to interventions (n = 134; 79%) and develop a care plan (n = 91; 54%). Length of time required to complete an OM and its clinical utility were the most common rationales for selecting an OM (n = 150, 88%; n = 147, 86%, respectively). Strong support was found for developing a core OM set for acute physical therapist practice (n = 147; 86%). The preferred methods for the organization of a core OM set, in rank order, were by diagnosis, International Classification of Functioning, Disability, and Health (ICF) framework, domains of health, and settings/location. Conclusion: Most physical therapists participating in this study of practice in acute care reported using OMs in their daily practice. This survey confirms the desire to develop a core OM set with high clinical utility for use in acute care settings.

Perception and Utilization of Standardized Outcome Measures in Acute Care Physical Therapy

“…It was composed of questions gleaned from previously published surveys and original questions development by the authors with input from a test group. 3,4,11,13 The 20-item survey was submitted to an expert review panel that included 3 staff acute care PTs, 2 PTs in leadership roles in acute care, 3 educators in doctor of physical therapy programs, and 1 director of an acute care residency program. They were asked to assess the face validity of the survey and provide comments on sources of error and clarity of questions.…”

Patient-Reported Outcome Measure Use by Acute Care Pediatric Physical Therapists

“…A survey by Jette and colleagues8 found that only 16% of acute care PTs were using OMs; however, the distinction between the frequency of using performance-based OMs versus PROMs was not noted in the study. Compared with the 2009 survey by Jette and colleagues,8 works by Mayer and colleagues9 in 2021 and Smith and colleagues10 in 2022 found an increase in consistent OM use in the acute care setting to 83% and 70%, respectively. In both contemporary studies,9,10 limited information about PROM use is included.…”

“…In the acute care setting, PROMs can be administered by physical therapists (PTs) to establish a baseline, inform decision-making, and guide discharge recommendations 7. Knowledge about PTs' utilization of PROMs in the acute care setting is limited to those working with adults7–10; the use of PROMs in pediatric acute care is unknown.…”

“…Historically, PTs have underutilized standardized outcome measures (OMs), especially in the acute care setting 7,8. Recent evidence suggests that consistent use of OMs occurs 70% to 84% of the time in acute care,9,10 an improvement from the 16% usage rate established by Jette and colleagues8 in 2009. While overall OM use has increased, PROM use was reported by only 4% of PTs in the acute care setting 10.…”

The Predictive Validity of Functional Outcome Measures With Discharge Destination for Hospitalized Medical Patients

“…Many were developed to support multi-disciplinary input and interpretation. 6 , 7 , 8 Our goal is to develop a study model and compare the different tools with respect to predictive value. We hypothesize that mobility score is analogous to a diagnostic test.…”