Document Type
Dissertation
Date of Degree
6-18-2025
Primary Advisor
Philip Van der Wees, PhD
Keywords
Emergency department physical therapy; emergency department; physical therapists
Abstract
Background: Although international models demonstrate the value of Emergency Department Physical Therapy (EDPT), adoption within U.S. hospitals remains limited. This study explored the experiences of emergency department (ED) medical directors and lead physical therapists (PTs) to identify barriers, facilitators, and strategies for broader EDPT implementation.
Objective: To examine how ED medical directors and lead PTs describe the implementation of embedded EDPT practice, including barriers, facilitators, and alignment with ED goals and performance indicators, with the ultimate goal of co-developing a tailored implementation strategy for U.S. hospitals.
Methods: This national, multi-phase, mixed-methods study included a survey, semi- structured interviews, and a focus group. Data were collected from ED medical directors and lead PTs to describe current practices, identify implementation barriers and facilitators, and collaboratively develop tailored strategies. The research team (PVDW, NND, ML) used REDCap for data collection and conducted qualitative analysis through inductive and deductive reasoning/coding approaches.
Results: Over a ten-month period, 20 hospitals participated in the study. Survey and interview data revealed six key themes aligned with the Consolidated Framework for Implementation Research (CFIR), based on insights from four ED medical directors and four lead PTs. A subsequent focus group with six PTs and two medical directors identified four focus areas to guide future implementation. Key findings included the critical role of relationships, communication, and team dynamics in EDPT success; the positive impact of EDPT on ED operations and workflow; the need for increased stakeholder awareness; favorable patient and provider outcomes; and financial implications that benefit systems and patients but challenge PTs. Participants also described the need for a shared vision for change within hospital systems.
Discussion: Findings support five essential implementation strategies for advancing embedded EDPT practice in the US: fostering a gradual culture shift, cultivating interprofessional relationships, selecting and developing skilled EDPTs, using data-driven advocacy, and engaging leadership to ensure sustainability.
Recommended Citation
Davis, Nikki Noelle, "Embedded Emergency Department Physical Therapy Practice: Essential Stakeholder Perspectives and Implementation Strategies" (2025). Doctor of Philosophy in Translational Health Sciences Dissertations. Paper 40.
https://hsrc.himmelfarb.gwu.edu/smhs_crl_dissertations/40
Open Access
1
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