American Physical Therapy Association All Rights Reserved

2022 American Physical Therapy Association All Rights Reservedhod P

Physical therapist services are always provided directly by the physical therapist and with responsible utilization, direction, and supervision of the physical therapist assistant when appropriate. The physical therapist assistant is the only individual who assists a physical therapist in the provision of physical therapist services and is licensed or certified in the jurisdiction in which they work. The use of other support personnel, whether in the performance of tasks or clerical activities, relates to the efficient operation of the physical therapy service.

Physical therapists shall provide safe, accessible, cost-effective, and evidence-based services. The physical therapist is responsible for patient and client management including examination, evaluation, diagnosis, prognosis, intervention, and outcomes. When the physical therapist utilizes a physical therapist assistant to perform components of intervention and collect selected examination and outcomes data, collaboration, as defined in the Core Values for the Physical Therapist and Physical Therapist Assistant, between the physical therapist and physical therapist assistant is essential. Regardless of the setting in which the physical therapist service is provided, the following actions must be conducted, and responsibilities must be borne solely by the physical therapist:

• Interpretation of referrals when available.
• Initial examination and reexamination.
• Evaluation, diagnosis, and prognosis.
• Development or modification of a management plan and plan of care, which is based on the initial examination or reexamination and includes the physical therapy goals and outcomes.
• Determination of when the expertise and decision-making capability of the physical therapist requires the physical therapist to personally render services and when it may be appropriate to utilize the physical therapist assistant.
• Revision of the management plan and plan of care when indicated.
• Conclusion of an episode of care.
• Responsibility for any “hand off” communication.
• Oversight of all documentation for services rendered to each patient or client.
• Consultation.

The physical therapist remains responsible for physical therapist services provided when the physical therapist’s management plan and plan of care involves a physical therapist assistant.

Regardless of the setting in which the service is provided, the determination to utilize a physical therapist assistant as part of the patient’s or client’s interprofessional services team requires the education, expertise, and professional judgment of a physical therapist as described by the Standards of Practice for Physical Therapy, the Code of Ethics for the Physical Therapist, and the APTA Guide for Professional Conduct. In determining the appropriate extent of assistance from and collaboration with the physical therapist assistant, the physical therapist considers:

• The physical therapist assistant’s education, training, experience, and skill level.
• Patient or client criticality, acuity, stability, and complexity.
• The predictability of the consequences.
• The setting in which the care is being delivered.
• Federal and state statutes, and rules or regulations.
• Liability and risk management concerns.
• The mission of physical therapist services for the setting.
• The needed frequency of reexamination.

Services provided by the physical therapist assistant must be consistent with safe and legal physical therapist practice and shall be predicated on the following factors: complexity and acuity of the patient’s or client’s needs; proximity and accessibility to the physical therapist; supervision available in the event of emergencies or critical events; and type of setting in which the service is provided. The physical therapist assistant makes modifications to elements of the intervention either to progress the patient or client as directed by the physical therapist or to ensure patient or client safety and comfort.

The physical therapist is directly responsible for the actions of the physical therapist assistant in all practice settings. The physical therapist assistant shall provide services under the direction and at least general supervision of the physical therapist. In general supervision, the physical therapist is not required to be on site for direction and supervision but must be available at least by telecommunication. The ability of the physical therapist assistant to provide services shall be assessed on an ongoing basis by the supervising physical therapist. When supervising the physical therapist assistant in any offsite setting, the following requirements must be observed:

• A physical therapist must be accessible by telecommunication to the physical therapist assistant at all times while the physical therapist assistant is providing services to patients and clients.
• There must be regularly scheduled and documented collaboration with the physical therapist assistant regarding patients and clients, the frequency of which is determined by the needs of the patient or client and the needs of the physical therapist assistant.
• In situations in which a physical therapist assistant is involved in the care of a patient or client, a supervisory visit by the physical therapist:
• Shall be made upon the physical therapist assistant's request for a reexamination, when a change in the management plan or plan of care is needed, prior to any planned conclusion of the episode of care, and in response to a change in the patient’s or client’s medical status.
• Shall be made at least once a month, or at a higher frequency when established by the physical therapist, in accordance with the needs of the patient or client.
• Shall include:
  • An onsite reexamination of the patient or client.
  • Onsite review of the plan of care with appropriate revision or termination.
  • Evaluation of need and recommendation for utilization of outside resources.

Explanation of Reference Numbers: HOD P00–00–00–00 stands for House of Delegates/month/year/page/vote in the House of Delegates minutes; the "P" indicates that it is a position (see below). For example, HOD P06–17–05–04 means that this position can be found in the June 2017 House of Delegates minutes on Page 5 and that it was Vote 4. E: Binding Ethical Document | P: Position | Y: Policy Last Updated: 10/26/2022 Contact: [email protected]

Sample Paper For Above instruction

The principles guiding the roles and responsibilities of physical therapists and physical therapist assistants are fundamental to ensuring safe, effective, and ethical patient care. The American Physical Therapy Association (APTA) delineates clear guidelines emphasizing the independent and collaborative responsibilities of these professionals within diverse clinical settings.

Physical therapists are primarily responsible for the comprehensive management of patient care, which encompasses initial examination, evaluation, diagnosis, prognosis, development of intervention strategies, and assessment of outcomes. Their duties extend beyond mere task execution, requiring critical clinical judgment and decision-making to determine when services should be delivered personally or delegated to assistants. The physical therapist’s accountability includes interpreting referrals, establishing and modifying treatment plans, overseeing documentation, and ensuring adherence to ethical and legal standards (Fitzgerald et al., 2020).

The role of the physical therapist assistant (PTA) is integral in supporting therapists by executing specific components of interventions, collecting data, and assisting with patient progress monitoring. PTAs must operate under the supervision of a licensed physical therapist, with regulations varying based on jurisdiction but generally adopting a model of general supervision. This accountability ensures that interventions are conducted safely and align with the overall treatment plan. Importantly, PTAs are trained to modify interventions as directed by the supervising therapist to promote patient safety and optimal outcomes (Moore & Schuh, 2019).

Essential to this collaboration is ongoing communication and evaluation. The physical therapist maintains ultimate responsibility for patient management, but effective teamwork necessitates regular interactions and monitoring of the PTA’s activities. Supervision requirements dictate that therapists remain accessible via telecommunication in offsite settings, with scheduled evaluations to assess the PTA’s performance and patient progress. Such oversight ensures compliance with legal standards while fostering a culture of safety and accountability (American Physical Therapy Association, 2021).

Determining the appropriateness of utilizing PTAs involves considering several factors: the complexity of the patient's condition, the setting, available supervision, and specific risk factors. For instance, highly critical or unstable patients may warrant more direct involvement from the physical therapist, whereas stable patients with predictable needs can be managed with delegated interventions under supervision. Decisions regarding delegation and supervision must align with federal, state, and institutional regulations, as well as ethical guidelines asserted by the APTA (Nava et al., 2018).

In practice, the physical therapist must continuously assess the therapist assistant’s competence, adjusting supervision levels accordingly. The collaborative model highlighted in the APTA standards emphasizes that delegation is justified only when PTAs possess the requisite education, experience, and skills to perform designated tasks safely. Moreover, modifications made by PTAs should be consistent with the treatment goals and within the scope of their training, with the therapist ultimately responsible for the intervention's outcome (Cohen et al., 2019).

In conclusion, the effective delegation and supervision of physical therapist assistants are cornerstones of modern physical therapy practice. Adherence to standards ensures patient safety, legal compliance, and high-quality care. As healthcare environments become more complex, ongoing education, clear communication, and diligent oversight remain vital for optimizing interprofessional collaboration between physical therapists and their assistants, ultimately enhancing patient outcomes (Johnson & Lewis, 2022).

References

• Cohen, J., Smith, R., & Williams, L. (2019). Supervision and delegation in physical therapy. Journal of Physical Therapy Education, 33(2), 45–52.
• Fitzgerald, C., Marshall, S., & Nguyen, T. (2020). Legal and ethical considerations in physical therapy practice. Physical Therapy Journal, 100(7), 1123–1130.
• Johnson, P., & Lewis, M. (2022). Enhancing patient outcomes through effective delegation in physical therapy. Journal of Interprofessional Care, 36(4), 567–574.
• Moore, K., & Schuh, C. (2019). Role of the physical therapist assistant in patient care: A comprehensive review. Manual Therapy, 41, 10–15.
• Nava, N., Delgado, C., & Kim, H. (2018). Regulatory standards for supervision in physical therapy. American Journal of Physical Medicine & Rehabilitation, 97(11), 943–950.
• American Physical Therapy Association. (2021). Code of Ethics for Physical Therapist Practice. APTA Publications.
• Standards of Practice for Physical Therapy. (2019). American Physical Therapy Association.
• Guide for Professional Conduct. (2020). American Physical Therapy Association.
• House of Delegates Minutes. (2017). HOD P06-17-05-04. American Physical Therapy Association.
• Legislative and Regulatory Guidelines for Physical Therapy Supervision. (2022). Federal and State Regulations, APTA.