Variation In Organizational Factors Influencing the Implementation of the Pediatric Annual Physical Therapy Visit

Hypothesis and Research Question: The research hypothesis is “Organizational Factors influencing the implementation of the Pediatric Annual Physical Therapy Visit (PAPTV) vary by practice setting, geographic location, and experience implementing the PAPTV.” The related research question is “How do organizational factors influencing the implementation of the PAPTV vary by geographic location, practice setting, and therapists experience with the PAPTV? Problem and Purpose of Research: While health promotion and wellness (HPW) initiatives are widely accepted as beneficial to both the patient and the healthcare system, the rollout of new initiatives is often challenging. The PAPTV has been a significant HPW initiative supported by the American Physical Therapy Association (APTA) and the Academy of Pediatric Physical Therapists (APPT). Despite the support of professional organizations, utilization of the PAPTV is limited. Organizational change strategies to enhance PAPTV utilization must target the specific organizational and clinical environments where the PAPTV will be utilized. To identify effective organizational change strategies, one must first understand the distribution of variation within the profession. This dissertation explores the variation in organizational factors impacting the implementation of the PAPTV in physical therapists who are Board Certified Pediatric Specialists through the American Board of Physical Therapy Specialists (ABPTS). Variation in organizational factors is explored through different practice settings, geographic locations, and experience implementing the PAPTV. Research Methodology and Summary of Procedures: A quantitative survey explored Pediatric Certified Specialists perceptions of organizational factors impacting the PAPTV from each of Bolman and Deal's four frames (Structural, Political, Human Resources, and Symbolic). Descriptive statistics explained trends in geographic regions, practice settings, and therapist experience with the PAPTV. Parametric (ANOVA), non-parametric (Kruskal-Wallis test), and Multiple regression analysis were used to analyze survey results to determine significant findings. Results and Conclusions: Variation was found within three of Bolman and Deal's four frames. The symbolic frame and human resources frame vary by the therapist's frequency of completing a PAPTV in one quarter. The political frame varies by region, specifically the Southeast and Pacific regions. The human resource frame was consistent across practice settings, geographic location, and experience implementing the PAPTV. These findings support the need for further research into the barriers of organizational change toward greater HPW within pediatric PT. Recommendations for Further Study Future research into organizational barriers toward greater HPW in pediatric physical therapy should be founded on various aspects of organizational strategy and change scholarship and utilize diverse investigative tools and methodologies. In quantitative research, utilizing the Organizational Culture Assessment Instrument and Competing Values Frame may shed light on cultural considerations impacting the change process. Including qualitative methodologies, such as ethnography, in research may help produce profound and comprehensive insight into organizational barriers toward HPW. Ongoing investigation utilizing organizational change and strategy scholarship, tools, and methodologies is needed to understand better organizational barriers towards greater HPW in pediatric physical therapy.