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Functional impact that is anticipated from physical therapy interventions.
Goals
Measurable statements regarding desired results
Objectives
Performing the activity in numerous environments, with new people and different equipment
Generalization
Members of the same profession work together without significant communication with members of other professions (PT, PTA)
Intradisciplinary
Oldest form of teaching; involves the LEAST ACTIVE INTERACTION among team members; interventions are provided individually by each discipline.
Multidisciplinary model
"Predicted optimal level of improvement in function and the amount of time needed to reach that level, and also may include a prediction of levels of improvement that may be reached at various intervals during the course of therapy"
Prognosis
Term used to describe cluster of signs and symptoms, arranged in syndromes or categories; based on results of the examination and evaluation process; may require collaboration with other health-care providers
Diagnosis
Performing the activity over time
Maintenance
Congenital muscular torticollis; spastic diplegia; osteochondritis dissecans of the knee; developmental coordination disorder; concussion/mild TBI
Current CPG's in pediatrics
Professionals work independently but recognize and value the contributions of other team members. Draws on knowledge from different disciplines, but there may be little interaction or ongoing communication among professionals.
Multidisciplinary
Desired outcomes determined first; extensive input from the child and family; strengths and obstacles to achieving the goals are determined; POC with appropriate interventions developed and implemented; commonly used (known problems or diagnosis, severe limitations in activities, and early intervention programs)
Top-down approach
Actual results of the plan of care
Outcomes
Documentation of achievement of increments toward the final goal; therapist writes a specific goal for child; develops the standard for each level of improvement toward achieving that goal; specific numeric values assigned to the expected levels of performance; considered more family centered and child centered
Goal attainment scaling (GAS)
1. Goals, objectives, or outcomes are achieved
2. Child or family declines to continue intervention
3. Child is unable to progress toward the anticipated goals, objectives and expected outcomes
4. Therapist determines that the child and family will no longer benefit from PT
Concluding an episode of care: discharge or "graduation" from services
There is teaching and ongoing work among team members that transcend traditional disciplinary boundaries. Team members work together to develop and carry out interventions. Role release occurs when a team member assumes the responsibilities of other disciplines for service delivery.
Transdisciplinary
Initial learning of a new activity
Acquisition
Not one of the Guide's six elements of patient and client management; developed in full collaboration with the child, family, and other service providers; includes measurable goals, objectives and outcomes; specific interventions to be used; proposed frequency and duration of services
Plan of care
Plans systematically developed to assist in health-care decision-making for specific clinical circumstances; based on focus groups, expert opinion, consensus, or EBP; helps determine most effective and appropriate interventions
Clinical practice guidelines (CPG)
Child and family related instruction; airway clearance techniques; assistive technology; biophysical agents; functional training in self care and domestic, work, community, social and civic life; integumentary repair and protection techniques; manual therapy techniques; motor function training; therapeutic exercise
Intervention
Individuals from different disciplines work together cooperatively to evaluate and develop programs. Emphasis is on teamwork, and role definitions are relaxed. There is analysis, synthesis, and harmony between disciplines, creating a coordinated and coherent whole
Interdisciplinary
More traditional approach; child's strengths and weaknesses are identified through the examination process; professionals determine the goals and objectives; more common in medical settings
Bottom-up approach
Developing proficiency at the activity
Fluency
"The purposeful interaction of the physical therapist with an individual and, when appropriate, with other people involved in that individuals care to produce changes in the condition that are consistent with the diagnosis and prognosis"; nine different categories
Intervention
Professional works independently of others
Unidisciplinary
All team members work together in equal participation and consensus decision making. The team interaction of the transdisciplinary model is combined with the integrated service delivery model. Coaching is a form of a collaborative team interaction.
Collaborative