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Innovative physical therapy practice: a qualitative verification of factors that support diffusion of innovation in outpatient physical therapy practice

Authors Sabus C, Spake E

Received 25 June 2016

Accepted for publication 23 August 2016

Published 1 December 2016 Volume 2016:8 Pages 107—120

DOI https://doi.org/10.2147/JHL.S115772

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Thomas Bart

Peer reviewer comments 5

Editor who approved publication: Professor Russell Taichman


Carla Sabus,1 Ellen Spake2

1Department of Physical Therapy and Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS, 2Rockhurst University, Kansas City, MO, USA

Background and purpose: New ideas, methods, and technologies spread through cultures through typical patterns described by diffusion of innovation (DOI) theory. Professional cultures, including the physical therapy profession, have distinctive features and traditions that determine the adoption of practice innovation. The Consolidated Framework for Implementation Research (CFIR) proposes a framework of innovation implementation specific to health care services. While the CFIR has been applied to medical and nursing practice, it has not been extended to rehabilitation professions. The purpose of this qualitative study was to verify the CFIR factors in outpatient physical therapy practice.
Design: Through a nomination process of area rehabilitation managers and area directors of clinical education, 2 exemplar, outpatient, privately owned physical therapy clinics were identified as innovation practices. A total of 18 physical therapists (PTs), including 3 owners and a manager, participated in the study.
Methods: The 2 clinics served as case studies within a qualitative approach of directed content analysis. Data were collected through observation, spontaneous, unstructured questioning, ­workflow analysis, structured focus group sessions, and artifact analysis including clinical documents. Focus group data were transcribed. All the data were analyzed and coded among 4 investigators.
Results: Through data analysis and alignment with literature in DOI theory in health care practice, the factors that determine innovation adoption were verified. The phenomena of implementation in PT practice are largely consistent with models of implementation in health care service. Within the outpatient practices studied, patient-centered care and collaborative learning were foundational elements to diffusion of an innovation.
Conclusion: Innovation in outpatient physical therapy practice can be understood as a social process situated within the culture of the physical therapy professional that follows predictable patterns that strongly align with DOI theory and the CFIR.

Keywords: innovation, organizational change, professional development, evidence-based practice

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