Guide to Physical Therapist Practice: Directed self study or group study questions, The

Neurology Report, Aug 1999 by Harro, Cathy C

The annual Neurologic Practice Issues Forum was held at Combined Sections Meeting in Seattle on February 5, 1999 and was titled: Neurologic Physical Therapy: Moving Into the 21st Century. This year's Forum focused on applying the Guide to Physical Therapist Practice to neurologic physical therapy. The Forum was well attended by participants from a wide variety of practice settings and many different areas of the country. The participants were organized into roundtables and engaged in lively discussion regarding how the Guide and its practice patterns are or could be incorporated into daily clinical practice. Clinicians reported numerous examples of successful application of the Guide, its language, its models and framework, and its practice patterns to clinical decision-making, documentation, peer review, utilization review, and case management of neurologic patients. The Guide has also been very helpful in educating physicians, managed care organizations, and insurers about the important role of physical therapy in management of neurologic patients. Some participants reported successfully using the Guide as a reference document to provide supportive rationale for recommended physical therapy services and justification of services billed to reviewers when claims were initially denied. Participants agreed that there is a critical need for physical therapists to be educated further on the contents and potential uses of the Guide. In many clinics across the country, physical therapists are not even aware that this document has been published or they have shelved the Guide without digging into its contents and applying the practice patterns. There was a strong concern that external agencies may be more eager to embrace the Guide as a reference document on the practice of physical therapy, than therapists themselves. Similar to clinicians across the country, forum participants varied greatly in their familiarity with the Guide. Some participants had only heard of this document but had not studied it in any depth. Others had a basic knowledge of the scope of the Guide and content in Parts I and II but had not incorporated use of its language or the practice patterns into their clinical setting. Those participants who had applied the Guide to their practice were eager to compare notes with others and share their concerns as well as their successes. Successes ranged from use of the Guide at an administration level, case management level, and in educating staff, other heath professionals, and physical therapy students.

Because of participants' varied levels of familiarity with the Guide, the forum was organized into roundtables with discussion questions geared at the introductory, intermediate, or more advanced application levels.The purpose of this report is to share these discussion questions in an effort to promote increased education on the Guide to Physical Therapist Practice and to encourage clinicians to apply the patient/management model and the practice patterns to their daily practice. These discussion questions can be used for self study or group study on the Guide. We found that the questions were very helpful at the Forum for facilitating discussion in small groups, as well as critically analyzing the practice patterns. The "Introductory Tour through the Guide" is geared towards Guide novices and gives a good overview for self-directed study on the basic contents in the Guide. The second section "Part Two: The Preferred Practice Patterns" was designed to encourage clinicians who were familiar with the Guide to apply the practice patterns to their clinical practice and daily management of neurologic clients. The section "Name That Pattern" requires classification of patients based on diagnosis and the rehabilitation focus for the current episode of care. Critical analysis of the practice patterns is facilitated through the section labeled "Guide: The Evolving Document." The third section,"Integrating the Guide into Clinical Practice," is geared for clinicians, administrators, or educators who are actively trying to incorporate the Guide into various aspects of physical therapy practice. These questions may also be helpful in generating ideas regarding potential strategies for application of the Guide to daily practice. By sharing these discussion questions from the Practice Issues Forum '99, the Practice Committee of the Neurology Section hopes to promote increased awareness and a more in depth understanding of the Guide to Physical Therapist Practice and its relevance to neurologic physical therapy. We encourage readers to share these questions with other clinicians and actively discuss them in staff meetings or study groups. Any feedback regarding the Guide to Physical Therapist Practice is welcome and should be directed to Practice Committee members or directly to Andrew Guiccione, APTA Department of Practice.

Cathy C. Harro, MS, PT NCS

Chair, Practice Committee