Award Date

12-1-2014

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Environmental and Occupational Health

First Committee Member

Sheniz Moonie

Second Committee Member

Tim Bungum

Third Committee Member

Paulo Pinheiro

Fourth Committee Member

Merrill Landers

Number of Pages

95

Abstract

The detrimental effects of inactivity and mobility extend to the most ill and injured patients in the acute hospital setting. Facilitating the activity and exercise of these most critical patients often requires the skill and expertise of a physical therapist. When physical therapists are involved in the care of hospital inpatients they experience significant benefits; patients experience fewer secondary complications related to their primary illness or injury, they spend less time in critical care units and less time in the hospital overall, and when they leave they go to less restrictive environments and more comfortable care settings. These known benefits can only occur when therapy is provided. Scheduling patients for needed therapy often results in no therapy being provided, termed non-treatment. It is documented that as many as 1 in 3 scheduled therapy sessions in the acute hospital never occur. This phenomenon of non-treatment is poorly described in the literature. In fact actual rates of non-treatment are only in 2 published reports and neither of these offer good evidence for the underlying cause. Therefore, the purpose of this dissertation is to explore the non-treatment phenomenon at two hospitals, describe the rates, therapist explanations, and associated factors related to the patient, therapist, and environment. Non-treatment events were examined for 4 years at one hospital and 6 months at the other. Statistical modeling with Generalized Estimating Equations was employed to quantify the association of variables on non-treatment events. The findings from this dissertation suggest that the therapist documented explanation for non-treatment events explains very little of its occurrence or variability; however, the treating therapists, patient diagnoses, and staffing and scheduling do significantly impact non-treatment.

Keywords

Hospital patients; Hospitals; Intensive care units; Non-treatment; Physical therapy; Productivity; Staffing

Disciplines

Physical Therapy | Physiotherapy

Language

English


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