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VHA Research

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Investigating physical therapy practice in the evolving ontario healthcare system: perspectives of physical therapists in homecare and stakeholders who work with them.

What's the challenge?

Ontario is currently moving towards an integrated care (IC) model via Ontario Health Teams, where individual healthcare practitioners will work more closely together as a single, cohesive team to place the patient’s needs at the centre. This change may require health care practitioners, such as physical therapists (PTs), to adapt their roles and skills to fit the new demands of working with a more collaborative approach. However, the current research about PTs in the integrated care setting is limited.

What are we doing?

This study aims to describe the experience of PTs working in an integrated homecare setting and the colleagues working with them, to better understand PT practice in the integrated care setting. One-on-one, semi-structured interviews will explore 1) the changes in physical therapy practice, 2) the competencies and skills of physical therapists necessary for success when working in and transitioning to integrated healthcare systems, and 3) the facilitators and barriers to optimizing physical therapy practice when working in and transitioning to an integrated healthcare system.

What have we found?

Twelve participants were interviewed. Seven physiotherapists, two operational stakeholders, and three system-level stakeholders shared perspectives on physiotherapy practice in IC which revealed four domains. Based on their positionality related to IC, participants perspectives diverged around (1) ambiguity in perceptions of IC, and (2) differing perspectives on changes to physiotherapy scope of practice. Whereas perspectives converged around (3) bringing forward existing expertise to work effectively in IC, and (4) emphasis on multi-level physiotherapy involvement moving forward.

This study highlights an opportunity for actively engaging PTs to help recognize and manage ambiguity to facilitate transitions into new healthcare models. Active engagement of PTs will also continue to emphasize leadership and non-clinical skills of PTs to allow them to contribute to the design, implementation, and evaluation of IC programs.