Hospital Physical and Occupational Therapy Co-Treatment: Practice and Perspectives

Background and/or Objectives: Hospital rehabilitation is provided to patients individually or through co-treatment sessions (acute care physical therapy [PT] and occupational therapy [OT] treat at the same time). Although common, there are currently no evidence-based guidelines for co-treatment, leaving delivery based on clinical judgment rather than scientific evidence. We aimed to identify self-reported 1) therapist and hospital characteristics associated with co-treatment practice, 2) documentation practices, 3) therapist views on clinical scenarios related to co-treatment.

Design: A national, descriptive cross-sectional survey was distributed and data was collected online via Research Electronic Data Capture (REDCap).

Setting : The survey was posted for 30 days in 2024 on two online forums accessible to members of national PT and OT organizations and on a social media platform with an acute care therapy audience. It encouraged therapists to forward to other therapists if interested.

Participants : Respondents consisted of a national sample of 669 occupational therapists, occupational therapy assistants, physical therapists, and physical therapist assistants working in the adult hospital setting 6 months prior to survey completion.

Interventions: The survey included 22 multiple choice questions including three sections designed to meet the aims.

Main Outcome Measures: 1) Proportions of respondents who co-treated, 2) documentation frequency on rationale and goals, 3) perspective on 9 scenarios.

Results: There were 631 (94%) therapists that reported co-treatment in the prior 6 months. The odds of co-treatment was 65% lower for PTs than OTs [OR 0.35, 95% CI 0.15-0.73]. Respondents who co-treated had 5.5 years less experience [-5.5, 95% CI -10 - -1.75]. Years of experience did not effect documentation of rationale. Therapists working in a department comprised of both disciplines were more likely to co-treat to improve workday flow, but not in other scenarios related to professional skills and relationships.

Conclusions: Co-treatment was highly prevalent, especially among PTs with less experience, with the most commonly reported scenarios reflecting improvement of workday flow.