Research paper|Articles in Press

Physiotherapy services in intensive care. A workforce survey of Australia and New Zealand

Published:December 26, 2022DOI:



      In Australia and New Zealand, there are currently no recommendations to guide staffing levels for intensive care unit (ICU) physiotherapy services, and there is limited information about the current services provided.


      The objective of this study was to document the profile of intensive care physiotherapy services currently offered in Australia and New Zealand.


      A binational survey was distributed to physiotherapists. The survey sought information on staffing and service profiles for weekday, weekend, and after-hour services including on-call and evening shifts.


      Eighty-six sites completed the survey, with responses primarily from Level 3 (47/86, 55%) and public ICUs (74/86, 86%). For weekday services, the ratio of full-time equivalent physiotherapy staff allocated per bed was similar between all intensive care levels (0.11 [0.08–0.15], p = 0.421). Thirty respondents (35%) were satisfied with their staffing and reported higher levels of physiotherapy staff per bed (0.15 [0.1–0.2], p < 0.001). Most sites reported lower levels of staffing for weekend services (76/86, 88%), and many physiotherapists indicated that they were not satisfied with this service (55/86, 64%). Most Level 2, Level 3, and paediatric ICUs had a designated senior physiotherapist, with similar levels of senior physiotherapy staff allocated per bed between all ICU levels (0.05 [0.03–0.08], p = 0.844). Few sites reported dedicated staff attributed to intensive care education, research, tracheostomy service, or outreach roles. On-call physiotherapy services were available in 49 of 86 (57%) hospitals surveyed; however, utilisation of the service by ICUs was mainly reported to be less than once per month (19/49, 39%).


      Physiotherapy staffing ratios were similar across different ICU levels. While weekend services are available for most ICUs, staffing levels are reduced. Higher staffing ratios were associated with higher levels of satisfaction to complete professional roles and responsibilities.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Australian Critical Care
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Berney S.
        • Haines K.
        • Denehy L.
        Physiotherapy in critical care in Australia.
        Cardiopulm Phys Ther J. 2012; 23: 19-25
        • Rodrigues A.
        • Munoz Castro G.
        • Jacome C.
        • Langer D.
        • Parry S.M.
        • Burtin C.
        Current developments and future directions in respiratory physiotherapy.
        Eur Respir Rev. 2020; 29
        • The Faculty of Intensive Care Medicine
        Guidelines for the provision of intensive care services (version 2.1).
        2022 (Available from:)
        • Becker E.A.
        • Hoerr C.A.
        • Wiles K.S.
        • Skees D.L.
        • Miller C.H.
        • Laher D.S.
        Utilizing respiratory therapists to reduce costs of care.
        Respir Care. 2018; 63: 102-117
        • Zaccagnini M.
        • Bussieres A.
        • Nugus P.
        • West A.
        • Thomas A.
        Exploring the professionalization of respiratory therapy in Canada.
        Can J Respir Ther. 2021; 57: 129-137
        • Twose P.
        • Jones U.
        • Bharal M.
        • Bruce J.
        • Firshman P.
        • Highfield J.
        • et al.
        Exploration of therapists' views of practice within critical care.
        BMJ Open Respir Res. 2021; 8
        • Wang Y.T.
        • Lang J.K.
        • Haines K.J.
        • Skinner E.H.
        • Haines T.P.
        Physical rehabilitation in the ICU: a systematic review and meta-analysis.
        Crit Care Med. 2022; 50: 375-388
        • Lang J.K.
        • Paykel M.S.
        • Haines K.J.
        • Hodgson C.L.
        Clinical practice guidelines for early mobilization in the ICU: a systematic review.
        Crit Care Med. 2020; 48: e1121-e1128
        • Devlin J.W.
        • Skrobik Y.
        • Gelinas C.
        • Needham D.M.
        • Slooter A.J.C.
        • Pandharipande P.P.
        • et al.
        Clinical practice guidelines for the prevention and management of pain, agitation/sedation, delirium, immobility, and sleep disruption in adult patients in the ICU.
        Crit Care Med. 2018; 46: e825-e873
        • Batchelor A.
        Adult critical care. GIRFT programme national specialty report.
        2021 (Available from:)
        • Jones J.
        • Jackwitz S.
        • Granger C.
        • Sorohan M.
        • Beach L.
        Physiotherapy model of service delivery in Australian tertiary trauma centres with Level III intensive care units.
        Aust Crit Care. 2015; 28: 50
        • Sun W.
        • Patman S.
        Benchmarking intensive care physiotherapy staffing in Australian tertiary hospitals.
        2008 (Available from:)
        • Twose P.
        • Terblanche E.
        • Jones U.
        • Bruce J.
        • Firshman P.
        • Highfield J.
        • et al.
        Therapy professionals in critical care: a UK wide workforce survey.
        J Intensive Care Soc. 2022; (In press, published online May 9)
        • Aranis N.
        • Molina J.
        • Leppe J.
        • Castro-Avila A.C.
        • Fu C.
        • Merino-Osorio C.
        Characteristics of physiotherapy staffing levels and caseload: a cross-sectional survey of Chilean adult Intensive Care Units.
        Medwave. 2019; 19e7578
        • College of Intensive Care Medicine of Australia and New Zealand
        Minimum standards for intensive care units.
        2016 (Available from:)
        • Critical Care Network National Nurse Leads
        National critical care non-medical workforce survey. Overview report.
        2016 (Available from:)
        • Ridley E.J.
        • Freeman-Sanderson A.
        • Haines K.J.
        Surge capacity for critical care specialised allied health professionals in Australia during COVID-19.
        Aust Crit Care. 2021; 34: 191-193
        • College of Intensive Care Medicine of Australia and New Zealand
        Guidelines on standards for high dependency units for training in intensive care medicine.
        2019 (Available from:)
        • Clancy H.
        • Johnson C.
        Design, organization and staffing of the intensive care unit.
        Surgery (Oxford). 2018; 36: 159-165
        • Wunsch H.
        • Pilcher D.V.
        • Litton E.
        • Anstey M.
        • Garland A.
        • Gershengorn H.B.
        Variation in bed-to-physician ratios during weekday daytime hours in ICUs in Australia and New Zealand.
        Crit Care Med. 2022;
        • Skinner E.H.
        • Thomas P.
        • Reeve J.C.
        • Patman S.
        Minimum standards of clinical practice for physiotherapists working in critical care settings in Australia and New Zealand: a modified Delphi technique.
        Physiother Theory Pract. 2016; 32: 468-482
        • Bonvento B.
        • Wallace S.
        • Lynch J.
        • Coe B.
        • McGrath B.A.
        Role of the multidisciplinary team in the care of the tracheostomy patient.
        J Multidiscip Healthc. 2017; 10: 391-398
        • Vegh L.A.
        • Blunt A.M.
        • Wishart L.R.
        • Gane E.M.
        • Paratz J.D.
        Managing deteriorating patients with a physiotherapy critical care outreach service: a mixed-methods study.
        Aust Crit Care. 2022;
        • Brusco N.K.
        • Paratz J.
        The effect of additional physiotherapy to hospital inpatients outside of regular business hours: a systematic review.
        Physiother Theory Pract. 2006; 22: 291-307
        • Haines T.P.
        • Bowles K.A.
        • Mitchell D.
        • O'Brien L.
        • Markham D.
        • Plumb S.
        • et al.
        Impact of disinvestment from weekend allied health services across acute medical and surgical wards: 2 stepped-wedge cluster randomised controlled trials.
        PLoS Med. 2017; 14e1002412
        • Raios C.
        • Keating J.L.
        • Stitt N.
        • Opdam H.I.
        • Skinner E.H.
        Challenges in providing timely physiotherapy and opportunities to influence outcomes for potential lung donors.
        Prog Transplant. 2017; 27: 112-124
        • Hodgson C.L.
        • Schaller S.J.
        • Nydahl P.
        • Timenetsky K.T.
        • Needham D.M.
        Ten strategies to optimize early mobilization and rehabilitation in intensive care.
        Crit Care. 2021; 25: 324
        • Nydahl P.
        • McWilliams D.
        • Weiler N.
        • Borzikowsky C.
        • Howroyd F.
        • Brobeil A.
        • et al.
        Mobilization in the evening to prevent delirium: a pilot randomized trial.
        Nurs Crit Care. 2022; 27: 519-527