Experiences of physical therapists working in the acute hospital setting: systematic review

Background. Physical therapists working in acute care hospitals require unique skills to
adapt to the challenging environment and short patient length of stay. Previous literature has
reported burnout of clinicians and difficulty with staff retention; however, no systematic
reviews have investigated qualitative literature in the area.
Purpose. The purpose of this study was to investigate the experiences of physical therapists
working in acute hospitals.
Data Sources. Six databases (MEDLINE, CINAHL Plus, EMBASE, AMED, PsycINFO, and
Sociological Abstracts) were searched up to and including September 30, 2015, using relevant
terms.
Study Selection. Studies in English were selected if they included physical therapists
working in an acute hospital setting, used qualitative methods, and contained themes or
descriptive data relating to physical therapists’ experiences.
Data Extraction and Data Synthesis. Data extraction included the study authors
and year, settings, participant characteristics, aims, and methods. Key themes, explanatory
models/theories, and implications for policy and practice were extracted, and quality assessment
was conducted. Thematic analysis was used to conduct qualitative synthesis.
Results. Eight articles were included. Overall, study quality was high. Four main themes
were identified describing factors that influence physical therapists’ experience and clinical
decision making: environmental/contextual factors, communication/relationships, the physical
therapist as a person, and professional identity/role.
Limitations. Qualitative synthesis may be difficult to replicate. The majority of articles
were from North America and Australia, limiting transferability of the findings.
Conclusions. The identified factors, which interact to influence the experiences of acute
care physical therapists, should be considered by therapists and their managers to optimize the
physical therapy role in acute care. Potential strategies include promotion of interprofessional
and collegial relationships, clear delineation of the physical therapy role, multidisciplinary
team member education, additional support staff, and innovative models of care to address
funding and staff shortages.