Are Productivity Goals in Rehabilitation Practice Associated With Unethical Behaviors?
Objectives: To evaluate the presence of productivity goals among licensed rehabilitation clinicians and their relationship with observed unethical behavior. Design: Exploratory, cross-sectional survey. Setting: Online. Participants: Licensed physical therapy clinicians (N=3446). Intervention: Not ap...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2019-06-01
|
| Series: | Archives of Rehabilitation Research and Clinical Translation |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590109519300011 |
| _version_ | 1830474793123577856 |
|---|---|
| author | Justin E. Tammany, DPT, ScD, MBA Janelle K. O’Connell, DPT, PhD Brad S. Allen, ScD Jean-Michel Brismée, ScD |
| author_facet | Justin E. Tammany, DPT, ScD, MBA Janelle K. O’Connell, DPT, PhD Brad S. Allen, ScD Jean-Michel Brismée, ScD |
| author_sort | Justin E. Tammany, DPT, ScD, MBA |
| collection | DOAJ |
| description | Objectives: To evaluate the presence of productivity goals among licensed rehabilitation clinicians and their relationship with observed unethical behavior. Design: Exploratory, cross-sectional survey. Setting: Online. Participants: Licensed physical therapy clinicians (N=3446). Intervention: Not applicable. Main Outcome Measure: Participants completed an electronic survey regarding use of clinical productivity goals. They rated the frequency in which they observed 6 unethical behaviors on a 7-point Likert scale in their practice setting from 1=never to 7=always. An overall observed unethical behavior score was calculated by summing these scales. Results: The response rate was 12.8% (N=3446), with analyses showing low risk of nonresponse bias. Many respondents (73.9%) had a formal productivity goal. Most (89.4%) reported observing some form of unethical behavior, but many (68.6%) reported it occurred “rarely” or “never.” Those in skilled nursing facility (SNF) settings reported higher frequencies of observance and were 4.1 times more likely to report more unethical behavior than the median compared with all other settings. A positive correlation existed between expected productivity rate and rate of unethical behaviors observed (ρ=0.225; P<.0001). Amounts of organizational emphases on ethical practice (ρ=−0.509; P<.0001) and evidence-based practice (ρ=−0.492; P<.0001) were negatively correlated with total observed unethical behavior. Conclusions: Use of productivity goals in rehabilitation practice is significantly related with rate of unethical behavior observed. Frequency of observed unethical behavior in rehabilitation practice was very low overall. Organizational culture appears to be a greater predictor of observed unethical behavior than any individual clinician-related characteristics. The SNF setting displays the greatest areas of ethical concern. Keywords: Efficiency, Ethics, Goals, Rehabilitation |
| first_indexed | 2024-12-21T15:25:50Z |
| format | Article |
| id | doaj.art-3af011eccde44daf933c0d45ad4aa216 |
| institution | Directory Open Access Journal |
| issn | 2590-1095 |
| language | English |
| last_indexed | 2024-12-21T15:25:50Z |
| publishDate | 2019-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Archives of Rehabilitation Research and Clinical Translation |
| spelling | doaj.art-3af011eccde44daf933c0d45ad4aa2162022-12-21T18:58:55ZengElsevierArchives of Rehabilitation Research and Clinical Translation2590-10952019-06-0111Are Productivity Goals in Rehabilitation Practice Associated With Unethical Behaviors?Justin E. Tammany, DPT, ScD, MBA0Janelle K. O’Connell, DPT, PhD1Brad S. Allen, ScD2Jean-Michel Brismée, ScD3Department of Physical Therapy, Holland School of Sciences and Mathematics, Hardin-Simmons University, Abilene, Texas, United States; Corresponding author Justin E. Tammany, DPT, ScD, MBA, 220 Hickory Street, Box 16065, Abilene, TX 79698.Department of Physical Therapy, Holland School of Sciences and Mathematics, Hardin-Simmons University, Abilene, Texas, United StatesDepartment of Rehabilitation Sciences, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, Texas, United StatesDepartment of Rehabilitation Sciences, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, Texas, United StatesObjectives: To evaluate the presence of productivity goals among licensed rehabilitation clinicians and their relationship with observed unethical behavior. Design: Exploratory, cross-sectional survey. Setting: Online. Participants: Licensed physical therapy clinicians (N=3446). Intervention: Not applicable. Main Outcome Measure: Participants completed an electronic survey regarding use of clinical productivity goals. They rated the frequency in which they observed 6 unethical behaviors on a 7-point Likert scale in their practice setting from 1=never to 7=always. An overall observed unethical behavior score was calculated by summing these scales. Results: The response rate was 12.8% (N=3446), with analyses showing low risk of nonresponse bias. Many respondents (73.9%) had a formal productivity goal. Most (89.4%) reported observing some form of unethical behavior, but many (68.6%) reported it occurred “rarely” or “never.” Those in skilled nursing facility (SNF) settings reported higher frequencies of observance and were 4.1 times more likely to report more unethical behavior than the median compared with all other settings. A positive correlation existed between expected productivity rate and rate of unethical behaviors observed (ρ=0.225; P<.0001). Amounts of organizational emphases on ethical practice (ρ=−0.509; P<.0001) and evidence-based practice (ρ=−0.492; P<.0001) were negatively correlated with total observed unethical behavior. Conclusions: Use of productivity goals in rehabilitation practice is significantly related with rate of unethical behavior observed. Frequency of observed unethical behavior in rehabilitation practice was very low overall. Organizational culture appears to be a greater predictor of observed unethical behavior than any individual clinician-related characteristics. The SNF setting displays the greatest areas of ethical concern. Keywords: Efficiency, Ethics, Goals, Rehabilitationhttp://www.sciencedirect.com/science/article/pii/S2590109519300011 |
| spellingShingle | Justin E. Tammany, DPT, ScD, MBA Janelle K. O’Connell, DPT, PhD Brad S. Allen, ScD Jean-Michel Brismée, ScD Are Productivity Goals in Rehabilitation Practice Associated With Unethical Behaviors? Archives of Rehabilitation Research and Clinical Translation |
| title | Are Productivity Goals in Rehabilitation Practice Associated With Unethical Behaviors? |
| title_full | Are Productivity Goals in Rehabilitation Practice Associated With Unethical Behaviors? |
| title_fullStr | Are Productivity Goals in Rehabilitation Practice Associated With Unethical Behaviors? |
| title_full_unstemmed | Are Productivity Goals in Rehabilitation Practice Associated With Unethical Behaviors? |
| title_short | Are Productivity Goals in Rehabilitation Practice Associated With Unethical Behaviors? |
| title_sort | are productivity goals in rehabilitation practice associated with unethical behaviors |
| url | http://www.sciencedirect.com/science/article/pii/S2590109519300011 |
| work_keys_str_mv | AT justinetammanydptscdmba areproductivitygoalsinrehabilitationpracticeassociatedwithunethicalbehaviors AT janellekoconnelldptphd areproductivitygoalsinrehabilitationpracticeassociatedwithunethicalbehaviors AT bradsallenscd areproductivitygoalsinrehabilitationpracticeassociatedwithunethicalbehaviors AT jeanmichelbrismeescd areproductivitygoalsinrehabilitationpracticeassociatedwithunethicalbehaviors |