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PPO 09-303 – HSR&D Study

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PPO 09-303
Survey of the Organizational Structure of the Physical Therapy Service in VHA
Patricia L. Sinnott PhD MPH PT
VA Palo Alto Health Care System, Palo Alto, CA
Palo Alto, CA
Funding Period: April 2010 - March 2011

BACKGROUND/RATIONALE:
There is increasing evidence that organizational structure has an important influence on quality of care and patient health care outcomes. In the rehabilitation sciences, and in Physical Therapy (PT) in particular, little is known about how the structure and organization of care might influence outcomes. This study aimed to create the framework to collect data describing the organizational environment in which PT Services are provided in VA. The long-term goal is to identify effective organizational models of care for the PT Service in VA. .


OBJECTIVE(S):
The specific aims of this pilot project, achieved through a collaborative effort between VA clinicians, service administrators and researchers, are to:

1) Develop a survey instrument that is useful for administrative and research purposes, designed to identify administrative and operational characteristics hypothesized to influence quality and outcomes of care for patients treated by Physical Therapists.
2) Gather pilot data from a sub sample of service managers.
3) Revise and finalize the survey instrument.




METHODS:
We convened a group of experts to develop the survey, including VA PT Planning Specialists, VA PT researchers and experts in survey design and organizational behavior. We pilot tested the survey with VAMC PT Supervisors. Qualitative feedback was obtained via two focus groups. The instrument is being finalized based on the pilot test and focus groups.

FINDINGS/RESULTS:
The draft survey instrument was pilot tested with a group of 20 VAMC PT Supervisors. In February 2011, we held focus groups with 12 of these VAMC PT Supervisors and obtained qualitative feedback on survey content and clarity. The survey instrument is being revised based on this feedback.

IMPACT:
The PT Service is a large patient care service in VA, employing more than 1,300 Physical Therapists and 350 Physical Therapist Assistants in all VISNs and all VA medical centers. Physical Therapists provide key clinical services for the recovery and rehabilitation of Veterans and, based on findings from other services, efficient and effective organization and administration of PT Services has the potential to improve outcomes. This pilot study will provide the framework to gather data on the structure and organization of the PT Service in VHA on an ongoing basis.



PUBLICATIONS:
None at this time.


DRA: Health Systems
DRE: Treatment - Comparative Effectiveness
Keywords: Clinical Performance Measures, Organizational Structure, Outcomes - System, Provider Performance Measures
MeSH Terms: none