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The Influence of a Move to Program Management on Physical Therapist Practice

PA Miller, PT, MHSc, is Assistant Clinical Professor, School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada. She was Profession Leader, Physiotherapy, Hamilton Health Sciences Corporation, Hamilton, Ontario, Canada, at the time of the study. Address all correspondence to Ms Miller at 5 Undercliffe Ave, Hamilton, Ontario, Canada L8P 3G9 (pmiller{at}mcmaster.ca)
P Solomon, PT, PhD, is Associate Professor and Assistant Dean, Physiotherapy Programme, School of Rehabilitation Science, McMaster University

Background and Purpose. The purpose of this qualitative study was to examine how a move to program management (PM) from a traditional department structure affected the professional practice of physical therapists in a large Canadian teaching hospital. Subjects. Twenty-five physical therapists participated in 1 of 5 focus groups, and 4 physical therapists participated in individual interviews. Methods. Focus groups and structured interviews were conducted by an experienced facilitator who was not a physical therapist. All focus groups and interviews were audiotaped and transcribed. Using an open-coding technique, 2 investigators undertook line-by-line analysis of each transcript to identify and code specific events related to the physical therapists' experiences. The investigators reached a consensus on all coding categories and then identified themes. Results. Seven themes that addressed issues of affect (a sense of loss, low morale, and positive coping), professional practice (loss of professional development activities, professional advantages, the assuming of multiple roles), and patient care were identified. Discussion and Conclusion. Physical therapists who were deployed from a department to a program described both positive and negative effects of the move to PM on their practice. There were reported influences on their personal affect, professional practice, and patient care. Staff and physical therapy administrators need to be aware of potential implications of an organization's move to PM on the professional practice of frontline staff.

Key Words: Hospital restructuring • Organizational restructuring • Professional practice • Professional roles • Program management