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        Complexity of hospital physical therapy is about making the right decisions: a grounded theory study.

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        Complex studie, Lieven de Zwart, 6227570, 27-6-2019.pdf (320.2Kb)
        Abstract complex studie, Lieven de Zwart, 6227570, Igitur.docx (13.10Kb)
        Keywords complex studie, Lieven de Zwart, 6227570, Igitur.docx (11.69Kb)
        Publication date
        2019
        Author
        Zwart, F.L. de
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        Summary
        Background: Physical therapy in a hospital setting is considered as a complex job, with a need for specific knowledge and skills. Complexity can influence providing the right care at the right time. To date, it is not known which variables contribute to the experience of complexity for hospital physical therapists (PTs). With this knowledge, it is possible to improve care for patients during the hospital stay by understanding the complexity of hospital physical therapy. Aim: This study aims to get understanding of complexity in hospital physical therapy care from the perspective of hospital PTs. Methods: A grounded theory study was performed to increase our understanding of experienced complexity. Semi-structured interviews were conducted in three hospitals with hospital PTs. Purposeful sampling was used in order to get maximum variation in rich cases. Interviews were transcribed, coded, and analyzed. A grounded theory was modelled after two research team meetings. Results: Twenty-four hospital PTs were interviewed. Experienced complexity is the process from experienced competence to the experience making the right decisions. Seven themes were identified: Being, becoming, and remaining competent; Disrupting the routine; Solving the puzzle; Dealing with unexpected and complicated factors; Taking responsibility; Feeling unfamiliar and uncomfortable; Making the right decisions. The grounded theory describes the process with complexity as an experience in the process of making the right decisions. Conclusion: The current study increases understanding in which themes are predominantly experienced when PTs talk about complexity of hospital physical therapy. This model could help understand the experienced complexity and the influencing factors and improve care by understanding when the routine gets disrupted and what helps to solve the puzzle. PTs should aim to become more competent, deal with unexpected and complicated factors, and take responsibility to lower the experience of complexity. The experienced complexity ultimately comes together in making the right decisions. Clinical Relevance: The abstract term complexity for hospital PTs has been given understanding. By understanding complexity, opportunities are presented to decrease the experienced complexity for PTs. Future research could further explore the influence of the setting and environment on complexity.
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        https://studenttheses.uu.nl/handle/20.500.12932/34121
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