The Influence of a Move to Program Management on Physical Therapist Practice

Abstract

Background and Purpose. The purpose of this qualitative study was to examine how a move to program management (PM) from a traditional department structure affected the professional practice of physical therapists in a large Canadian teaching hospital. Subjects. Twenty-five physical therapists participated in 1 of 5 focus groups, and 4 physical therapists participated in individual interviews. Methods. Focus groups and structured interviews were conducted by an experienced facilitator who was not a physical therapist. All focus groups and interviews were audiotaped and transcribed. Using an open-coding technique, 2 investigators undertook line-by-line analysis of each transcript to identify and code specific events related to the physical therapists' experiences. The investigators reached a consensus on all coding categories and then identified themes. Results. Seven themes that addressed issues of affect (a sense of loss, low morale, and positive coping), professional practice (loss of professional development activities, professional advantages, the assuming of multiple roles), and patient care were identified. Discussion and Conclusion. Physical therapists who were deployed from a department to a program described both positive and negative effects of the move to PM on their practice. There were reported influences on their personal affect, professional practice, and patient care. Staff and physical therapy administrators need to be aware of potential implications of an organization's move to PM on the professional practice of frontline staff. [Miller PA, Solomon P. The influence of a move to program management on physical therapist practice. Phys Ther. 2002;82:449 -458.]

Meeting the Challenge of Assessing Clinical Competence of Occupational Therapists within a Program Management Environment

“…It is not surprising, therefore, that Cyr, Arturi, Seguin, and Egan (2001) have discussed the difficulty of "living and growing as an occupational therapist under program management" (p. 14). Miller and Solomon (2002) have reported similar problems with program management models when profession-specific performance issues arise. Miller and Solomon even suggest that there is a possibility of competence deteriorating as a result of being isolated from colleagues in the same profession.…”

“…As a result, new positions for professional practice leaders (one per disciplinary group) were created as a means to provide informal leadership within each group. Miller and Solomon (2002) point out that one of the main responsibilities of the professional practice leader is to ensure the quality practice of the occupational therapy staff.…”

Development of quality indicators for departments of hospital-based physiotherapy: a modified Delphi study

“…14 15 Hospitals nowadays struggle how to organise these changing roles: a move to programme management from a traditional department structure affects the professional practice of physiotherapists, reporting both positive and negative effects on professional affect, professional practice and patient care. 16 A quality system for an individual profession such as hospital-based physiotherapy should be based on a common framework for effective quality management to which this specific profession can better identify, and which is independent of hospital restructuring. Because such a system is lacking, the aim of this study is to identify the most important indicators for the quality of a hospitalbased physiotherapy department in the eyes of hospitalbased physiotherapists and their managers, as a first step towards establishing a valid and useful quality system for the profession.…”