The physical therapy profession doesn't shy away from a challenge — and that reality was on full display at the 76th APTA House of Delegates, which set the stage for the profession's centennial by not only taking on important professional and societal issues but doing so in an entirely new way.
In many aspects, the 2020 House resembled its predecessors in terms of the range of topics addressed, from broad concepts such as telehealth to the nuts-and-bolts of internal House operations. But there was one major difference: The entire event was conducted virtually, as most of the country continued to live under travel and in-person meeting restrictions in light of the COVID-19 pandemic.
Circumstances demanded that the House quickly adapt. APTA announced its decision to suspend all in-person meetings on March 11; by early June, the association was able to offer an online House experience that allowed for nearly every facet of an in-person version. Delegates learned the technical ins and outs and stepped up to the challenge, tackling a long list of items through, as always, lively debate.
Over the course of the session, actions taken by the House tended to coalesce around a few common themes.
The Expanding Impact of the PT and PTA
Just as the association prepares to mark its 100th year, the House focused a significant part of its efforts on supporting APTA's vision for the future by looking at the profession's role in health care more broadly.
Telehealth. The Increased use of telehealth during the COVID-19 pandemic has highlighted the need to establish best-practice strategies for its use, according to a charge passed by the House for the development of appropriate guidelines by APTA.
Behavioral and mental health. The House adopted a position articulating APTA's support for greater interprofessional collaboration around mental health and its relationship to physical therapist practice, describing PTs as professionals capable of screening for and addressing "behavioral and mental health conditions in patients, clients, and populations."
Sleep health. A new position adopted by the House promotes greater collaboration between PTs and sleep medicine professionals, and it supports the profession's role in prevention and management of sleep impairments as well as promotion of healthy sleep behaviors.
Emergency practice. The House adopted a resolution stating APTA's support for emergency PT services, describing this area of practice as occurring in "hospital-based and freestanding emergency departments, urgent care clinics, observation units, athletic events, emergency medical response vehicles, and disaster sites," among other settings. It also directed the association to "identify barriers to and opportunities for provision of emergency physical therapist services" and to develop related resources.
Professional Values, Ethics, and Standards
The House also addressed the profession's present environment by refining some of the most important guidance around principles and behaviors that are core to day-to-day practice.
Values in the association's ethics and conduct guidance. The House voted to fold in the core values for the PT and the PTA into the Code of Ethics for the Physical Therapist and Standards of Ethical Conduct for the Physical Therapist Assistant. Previously the core values existed as a separate document cited in those two documents — a separation that was potentially problematic.
Standards around patient and client management. The House voted to modernize the Standards of Practice for Physical Therapy around patient and client management to better encompass the full scope of PT practice. In addition to cleaning up ambiguities, the new standards now include expanded language related to management plans and plans of care and consultation.
Patient safety. The House adopted a position on patient safety that establishes APTA's support of efforts by PTs and PTAs to achieve the goal of "zero preventable patient harm by demonstrating transformational leadership, a culture of safety, and robust performance improvement."
Environmentally responsible practice. The House updated APTA's position on its support for more environmentally conscious practices "for the health of individuals, communities, and society." That support now includes a commitment to environmental sustainability and greater public awareness of the effect of the environment on human movement, health, and safety.
World Confederation for Physical Therapy meeting location. Delegates voted for the association to act on concerns about WCPT's selection of Dubai, United Arab Emirates, for its 2021 conference, given the country's poor human rights record. Those actions include an official censure of the decision; a statement that APTA supports WCPT meeting site selections that are consistent with the confederation's current policy statement related to diversity, equity, and inclusion; and a directive for APTA to introduce two motions at the 2023 WCPT general meeting: one that would commit WCPT to selecting meeting sites that are consistent with its policies on diversity and inclusion, and a second that would add language to the WCPT inclusion statement to clarify that "All members of the global physical therapy community must be able to attend … without fear of governmental persecution on the basis of race, creed, color, sex, gender, gender identity, gender expression, age, national or ethnic origin, sexual orientation, disability, or health status."
Workforce and Education Issues
From practice arrangements to the need for greater transparency in the cost of physical therapy education, the House addressed some of the most pressing issues facing the current and future workforce.
Transparency of accredited physical therapy education programs. As approved at the House, APTA now has an official statement urging physical therapy education programs to provide full disclosure of the costs of their degree programs, and to improve the financial literacy of students.
Practice and business financial arrangements. In a continuation of shifts in 2019 that moved APTA toward a focus on the underlying operations of various business and financial arrangements more than the types of relationships themselves, the House adopted a new APTA position in support of collaborated practice and business models. That support is limited to arrangements that are consistent with APTA positions and policies, prioritize best clinical practice, provide consumer value and choice, are data-driven, retain "organizational flexibility," and comply with laws and regulations.
Workforce planning. The House also confirmed the importance of in-depth workforce planning and regular reporting to ensure an adequate physical therapy workforce that meets the current and future needs of society. Those planning efforts would include ongoing assessments of supply and demand, as well as needs assessments that would help better define and predict the employment landscape.
Recruiting and hiring internationally educated PTs. The House amended APTA guidelines providing safeguards for PTs trained outside of the U.S., and for employers interested in hiring these PTs. The new guidelines are intended to provide more support for these PTs, including more employer responsibilities and greater transparency.
Association Governance
In addition to the outward-facing actions taken, the House also addressed issues related to internal operations. Among the most notable: granting APTA sections and academies voting rights at the House, and adding a position for a public member on the APTA Board of Directors. The public member will be appointed by the Board.