T-2 Dedicated Burn Therapists and Verification Status: National Survey of U.S. Burn Centers

Abstract Introduction Burn survivors require ongoing therapy for years post-discharge to prevent contractures, restore independence, and manage scarring. Having trained and skilled occupational and physical therapists (OT/PT) in the follow-up outpatient (OP) burn clinic to address ongoing rehabilitation and reconstruction needs is essential for comprehensive long-term care. While the ABA verification process promotes OT/PT in OP burn clinics, barriers such as space, time, and staffing are common constraints for burn programs. Little is known about real-world integration of OT/PT within OP burn clinics. This study examined the utilization of OT/PT in OP burn clinics and examined associations with clinic structure, patient services, and verification status. Methods U.S. burn centers were sent a 20-question electronic survey. Questions addressed clinic structure and resources, staffing utilization, and verification status. Responses were received from 54 (43%) of burn centers. Frequencies and percentages described categorical variables. Fisher’s exact and Chi-square analyses estimated associations using verification status and designated OP therapists as outcomes, respectively. Firth logistic regression was applied to account for small sample sizes. Results Of the responding burn centers, 35 (65%) reported having dedicated OT/PT staff in the OP burn clinic, 33 (61%) were ABA-verified, and most (30, 56%) treated both adult and pediatric patients (Table 1). On bivariate analysis, the presence of designated OT/PT was significantly associated with verification status (p=.007). Centers with dedicated OT/PT were also more likely to place therapy orders directly in OP clinic (p.001), provide therapy treatment at follow-up (p=.020) and after reconstruction surgery (p=.027), offer patient transportation for follow-up (p=.024), and have a compression garment program (p=.017). Verified centers were more likely to have burn surgeons responsible for reconstruction programs (85% vs. 15%), while in non-verified centers, responsibility was more evenly divided between burn surgeons (57%) and external plastic surgeons (43%). After controlling for burn reconstruction program, centers with designated OT/PT had over three times the odds of being verified compared to those without (OR = 3.5, p=.043). Conclusions While ABA-verified burn centers were more likely to report dedicated OT/PT services in their outpatient clinics, it was the presence of these therapists that was associated with broader rehabilitation resources, including follow-up interventions and compression garment programs. These findings suggest that verification supports the integration of therapists, but that therapist presence itself is the critical factor driving comprehensive long-term rehabilitation. Applicability of Research to Practice ABA verification promotes OT/PT integration, and therapist presence improves access and continuity of care. Funding for the study N/A.