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Safety Events and Privilege Utilization Rates in Advanced Practice Physical Therapy Compared to Traditional Primary

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Advanced practice physical therapy (PT) demonstrates a comparable safety profile to primary care, with fewer safety events reaching patients. This suggests PTs can safely manage musculoskeletal care, reducing the need for imaging and referrals.

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Area of Science:

  • Musculoskeletal Health
  • Healthcare Policy
  • Patient Safety

Background:

  • Growing demand for musculoskeletal care due to physician shortages and an aging population.
  • Physical therapy (PT) is proposed to fill gaps in primary care for musculoskeletal conditions.
  • Concerns exist regarding patient safety as PTs expand their scope of practice.

Purpose of the Study:

  • To compare the rate of safety events and service utilization in an advanced practice PT clinic versus a primary care clinic.
  • To assess patient risks associated with advanced practice PT compared to primary care.
  • To report safety events related to spinal manipulation and dry needling.

Main Methods:

  • Retrospective data collection from 2015-2017 at Malcolm Grow Medical Center.
  • Comparison between a Family Health Clinic (FHC) and an advanced practice Physical Therapy Clinic (PTC).
  • Statistical analysis using chi-square tests, risk ratios (RR), and 95% confidence intervals (95% CIs).

Main Results:

  • Advanced practice PT clinics had a higher proportion of near-miss safety events (75%) compared to primary care (50%).
  • Safety events were less likely to reach patients in the PT clinic (RR 1.9) than in primary care.
  • PT clinics utilized significantly fewer diagnostic imaging studies and referrals compared to primary care.

Conclusions:

  • Advanced practice PT exhibits a safety profile comparable to primary care.
  • Expanded PT scope, including ordering imaging and referrals, is crucial for advanced practice clinics.
  • Advanced practice PT can potentially reduce specialty referrals, diagnostic imaging, and pharmaceutical interventions.