Often a physical therapist may compromise in providing quality treatment with a larger quantity of OPD or IPD...
hi, you have mentioned more with more quantity the quality is compromised, the first step should be to increase the man power.
But if the that is not possible then the physical therapist can focus on making proper 'short term and long term goals'
Sometimes we as therapist give unnecessary time to one patient which leaves less time for next patient and we are unable to deliver the proper treatment.
The team of therapists should divide the work and should have a team effort under pressure rather relying on a single therapist for all the work.
Another thing that can improve quality of work is evidence based practice rather the obsolete time consuming treatment methods we should go EBP.
Nevertheless ....your questions covers a wide range of variables effecting the quality of work.
Hi Hira as you are mentioning about the men power I would like to continue the question - how many no of patients a physiotherapist should attend in a day?
Ratan, i have worked 6 years as manual therapist .... i have attended 8-10 patients (all those who needed manual therapy (i.e joint mobilization, soft tissue manipulation, manual resistance etc) but i did notice that after 6 patients i was not able to give 100% physically. If therapist is consultant who only has to assess and diagnose and rest of work is done by others then, i think one can attend as many patients coming in OPD. :)
Hi Ratan,
I agree with your concern bout the lowering of the standards of physiotherapy at the cost of treatment effectivity. But at the same time I would also like to say that time management is something which all physiotherapist should be taught better. Infact this is one thing which is not emphasized at our educational levels. More time does not always mean better management. in fact time management can be improved if planning is done in a better manner and appointment system is followed.
@ Zubia, I agree with your input. Whether good time management can get from evidence based practice?
I agree with ZUBIA VEQAR... Most the PTs and other professionals think spending more time can bring better management and so PTs are unknowingly getting forced to spend too much unquality time with patients.... So PLANNING is MUST before treatment..... Be specific
Dear colleagues,
The question ‘How can we improve the quality of physiotherapy treatment in clinics and hospital setups? ‘ is a very important question for the profession of physiotherapy (PT).
The first step towards improving the quality of PT is to gain insight into the actual care. To conclusively estimate such quality of care, valid quality indicators (QIs) are required to fill the gap between evidence from guidelines and PT practice in clinics and hospital setups. QIs are seen as the cornerstone of the quality of PT practice.
QIs have been defined as ‘measurable elements of practice performance for which there is evidence or consensus that they can be used to assess the quality, and thus change the quality, of care provided’. QIs are related to structures (such as staff, equipment, appointment systems), processes (such as prescribing, investigations, clinical reasoning) or outcomes (such as mortality, morbidity, patient satisfaction or functioning) of care . The PT
care process is based upon solid clinical reasoning. As a consequence, clinical reasoning is ideally suited to measure the intrinsic quality of PT care. Clinical reasoning has been defined as ‘a process in which the therapist, interacting with the patients and significant others, structures meaning, goals and health management strategies based on clinical data, client choices and professional judgment and knowledge’. Through the diagnostic process (history taking and establishing objectives for the subsequent physical examination, physical examination, analysis and conclusion), the therapeutic process (treatment plan and treatment) and evaluation process (evaluation during the treatment and at discharge) outlined in the clinical practice guideline (CPG) on requirements for PT documentation, the therapist attempts to understand a patient’s problem in full sense.
The transparency of clinical reasoning process in measurable elements such as QIs is seen as the cornerstone of the quality of PT care. The measurability of clinical reasoning process can be supported by the development of a valid set of QIs. QIs are preferably derived from guideline-based recommendations, supplemented by expert clinical experience and patient perspectives and developed by means of a systematic method. After development, sets of QIs should be subjected to a pilot practice test based in primary care, clinics and hospital settings on an overall indicator testing protocol. Certain key attributes, such as clarity, relevance, necessity, measurability, feasibility, improvement potential, acceptability and
implementation, can only be properly assessed in daily practice.
Our research group has a great experience in the development and evaluation of guidelines based QIs in different groups of patients (for instance Parkinson, arthritis, neck pain, low back pain). You can find all the published articles, uploaded in Research Gate.
The primary goals of this part of discussion are to enhance the development of process and outcome QIs relevant to patients in clinics and hospital setups and to subject this set to a pilot practice test to determine its value in assessing the actual quality of PT care.
Nijmegen, May 5, 2014
Em. Prof. Rob A.B. Oostendorp, PhD, MSc, PT, MPT
Radboud University Nijmegen, The Netherlands
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