Chapter 1 Managing Change

Focus
The focus of this chapter is to identify the ways in which the physical therapist's role priorities have changed.

Why is it Important to Learn This?
It is important to help students look at the changing aspects of the role, as the assumptions they hold may be quite different. My experience has been that if an instructor is aware that the graduate student is being prepared to take on a role that is clearly different from the models and ideas that have existed in the past, it becomes more motivating to embrace some of the strategies and skills that will ensure success in these new roles. This chapter really sets the stage for the development of the context for the role, specific practice settings, professional issues, modes of service delivery, and strategies that are covered in Chapters 2 through 14.

Chapter 2 Basics of Health Care Financing and Reimbursement

Focus
This chapter focuses on the presentation of mechanisms for paying for health care and supplying payment to providers.

Why is it Important to Learn This?
This knowledge underlies all legislative and policy changes that currently shape health care delivery. The forces in motion are powerful determinants of practice priorities, limitations, and resource constraints. The provider needs this knowledge to develop effective strategies for productive practice in the current health care environment.

Chapter 3 Cost-Containment Strategies

Focus
This chapter focuses on mechanisms for containing costs from the perspective of the third-party payer and provider.

Why is it Important to Learn This?
Cost-containment concerns drive health care reform. Many recent prospective payment initiatives have markedly limited third-party reimbursement for health care services. Creative intrasystem cost-containment strategies may make it possible to continue to provide effective services within these restrictions. However, these solutions must be discussed in light of legal and ethical considerations.

Chapter 4 Referral and Access to Physical Therapy Services

Focus
This chapter focuses on the factors that influence access to physical therapy in today's health care environment, the relationship of access and reimbursement, and barriers that may prevent the patient from accessing physical therapy services.

Why is it Important to Learn This?
Patients benefit from needed rehabilitation services. Access may be limited due to third-party payer resource constraints, required referral relationships, or limited availability of physical therapy services. Identification of access barriers is critical to planning efficient service delivery for people who need rehabilitation services.

Chapter 5 Trends and Strategies for Physical Therapy Practice in Acute Care

Focus
This chapter focuses on trends and strategies for physical therapy practice in acute care settings. Comorbidity, decreased length of stay, discharge and treatment planning, and trends in acute hospital restructuring are covered in depth.

Why is it Important to Learn This?
Health care in acute hospitals has changed markedly in the past two decades. It is important for physical therapists to understand the continuing evolution of the acute care setting and how these changes have affected the practice of physical therapy. By understanding the nature of these changes and factors influencing the focus of practice, physical therapists can develop effective patient management strategies.

Chapter 6 Trends and Strategies for Physical Therapy Practice in Subacute Care

Focus
This chapter focuses on the definition, characteristics, and trends of subacute care. This practice setting has undergone marked changes with the implementation of the Balanced Budget Amendment of 1997, limiting payment for physical therapy services under both Medicare Parts A and B.

Why is it Important to Learn This?
This practice sector comprises a significant portion of physical therapy service delivery. The continuing evolution of policy change in this setting dictates constant vigilance on the part of educators, administrators, and clinicians to analyze implications for rehabilitation service delivery. As it is likely that policies will continue to change, instructors who use this material should indicate to students that the latest and most up-to-date information is available via websites and in active practice settings rather than in textbooks.

Chapter 7 Trends and Strategies for Physical Therapy Practice in Home Health Care

Focus
This chapter focuses on the trends and growth in the home health care industry and the physical therapist's role in providing care in this practice setting. This practice setting has also been affected by Balanced Budget Amendment policy changes.

Why is it Important to Learn This?
As pressures increase to discharge patients from inpatient care settings, more patients are at home sooner and sicker. The challenges of practice in this setting continue to change. Exposure to the realities and requirements of clinical practice is important as students make career decisions and as they refer patients for home health care services. It is especially important to realize the impact of the interdisciplinary team in providing home health services.

Chapter 8 Time Management Techniques

Focus
This chapter focuses on strategies to identify priorities, and organize and manage job responsibilities in clinical practice settings. It presents practical techniques and ideas for implementation in a variety of clinical settings.

Why is it Important to Learn This?
Perceived lack of time to address key priorities is a significant source of stress on the job. Reduced staffing allocations, diminishing resources, and increasing responsibilities create a high potential for burnout and stress on the health care provider.

Chapter 9 Caseload Management and Delegation

Focus
This chapter addresses issues of caseload management and delegation, specifically in managing clinical duties, carrying out treatment responsibilities, and in communicating and working with others to provide clinical services. The chapter includes coverage of ethical and legal issues involved in providing these services, including supervisory requirements of support staff.

Why is it Important to Learn This?
Caseload management presents many dilemmas in clinical practice. Analysis of clinical tasks, identification of resource constraints, evaluation of support staff capabilities, and organizational needs are required to carry out ethical, legal, and efficient service delivery in our complicated health care environment.

Chapter 10 Measuring Outcomes of Physical Therapy

Focus
This chapter covers the fundamental principles of outcomes measurement, data collection, and analysis. This includes models of disablement and function, especially as they relate to the selection of outcome indicators and measures of improvement.

Why is it Important to Learn This?
Outcomes are of increasing importance to illustrate the efficacy of treatment approaches in today's health care environment. Both economic and political forces have greatly influenced current systems of health care delivery. With increasing emphasis on evidence-based practice, and cost containment and resource constraints, it becomes imperative that physical therapists are able to demonstrate the efficacy of their services in improving the function of their patients and clients.

Chapter 11 Documentation Requirements

Focus
This chapter covers the criteria for acceptable documentation in an evidence-based practice environment. The author explains acceptable criteria for Medicare documentation and offers many examples, and do's and don'ts for documentation to facilitate reimbursement.

Why is it Important to Learn This?
Documentation serves as a legal record of services provided and gives third-party payers sufficient justification to reimburse providers for those services. Evidence of treatment efficacy needs to be reflected in physical therapist documentation. In addition, effective skills in documentation will facilitate clear, consistent interprofessional communication.

Chapter 12 Utilization Management

Focus
This chapter presents an introduction to the utilization management process, including both internal and external review processes. The conduct and criteria for review are presented.

Why is it Important to Learn This?
Utilization management ensures that each patient qualifies for the level of care he or she is receiving through prevention of prolonged lengths of stay, excessive number of visits, and unnecessary treatment. This process is strongly linked to good patient care documentation to justify the level of care being provided.

Chapter 13 Quality Management in Physical Therapy

Focus
This chapter defines quality-related processes such as quality assurance, quality management, and quality improvement as well as the indicators that are often used in such programs.

Why Is It Important to Learn This?
Quality management is a critical standard for physical therapy practice and mandatory for most institutional accreditation certifications. Physical therapists must often develop mechanisms for measuring quality and strategies for addressing specific target areas. Quality management interfaces with outcomes management and utilization review. Together, these processes assure accountability, efficacy, and continued evidence that physical therapy services are meeting acceptable standards of care.

Chapter 14 The Role of Physical Therapist in Prevention

Focus
This chapter includes definitions of the physical therapist's role and strategies for practice in primary, secondary, and tertiary prevention.

Why is it Important to Learn This?
The American Physical Therapy Association's (APTA) Model Definition of Physical Therapy for State Practice Acts includes prevention and wellness in its definition of physical therapy. Physical therapists often serve as educators, playing a key role in prevention and wellness in areas such as worksite wellness, osteoporosis prevention, arthritis intervention, fall prevention, and providing educational services for patients and caregivers on disease.

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