Setting
Barriers to implementing physical therapy include a lack of leadership support and a culture that favors pharmacological approaches, while facilitators include strong internal communication among healthcare professionals, access to resources, and a positive organizational climate.
Barriers
When organizational leaders do not prioritize or openly support the integration of PT, implementation can be challenging. This can lead to perceptions of limited importance, leading to a lack of resources or buy-in from the organization.
Clinic cultures deeply rooted in pharmacologic care as the first-line treatment for pain can be a barrier to PT adoption. Staff may be resistant to change, and PT implementation may not align well with established workflows or beliefs.
Limited communication channels between PT providers and staff or leadership can create difficulties in meaningful PT implementation and adoption. For example, a misunderstanding of a PT program’s goals or how it fits into existing care pathways can lead to fragmented care and potentially bad outcomes.
While many health systems offer PT services integrated within their delivery networks, standalone outpatient services remain a common delivery model. This model can hinder coordinated and interprofessional care, making it difficult for patients to access services as part of a comprehensive pain care plan.
Limited resources, such as funding and suitable clinic space, can hinder the delivery of PT, restricting patient access and potentially affecting service quality.
Facilitators
Clear and consistent communication from all staff and healthcare professionals can help build a shared understanding of a PT program’s goals and benefits to patients.
Supportive leadership within healthcare organizations that champions the integration of PT facilitates smoother implementation and promotes wider access to this care option for patients. An organizational culture that is open to innovation and values evidence-based practices is a powerful facilitator.
Internal champions (e.g., on-staff physical therapists) can facilitate PT uptake for patients. This individual can provide training, answer questions, and act as a resource to help other staff members feel more confident in referring patients to PT.
Strong working relationships and communication between different departments, such as primary care and pain management, can streamline referrals and improve patient care coordination. These established networks can help to embed new PT pathways into the existing clinical workflow more easily. They also allow the physical therapist to meaningfully collaborate with other clinicians within a larger network, delivering evidence-based pain care.