Foundation Researcher Spotlight: Daniel Young Bridging Gaps in Hospital Care

Daniel Young, PT, DPT, PhD is an associate professor at the University of Nevada, Las Vegas. He is the recipient of the 2022 Magistro Family Foundation Research Grant in 2022.

Can you tell me a little bit about yourself and your personal background?

I’m originally from Nevada, where I completed my high school education. My academic journey took me to Southern Utah University for my undergraduate studies in biology and later to Creighton University in Omaha, Nebraska, where I pursued my Doctor of Physical Therapy (DPT). I spent an unexpected eight-year stint in Omaha which ignited a love for the Midwest. Then I came back to Nevada, to the University of Nevada, Las Vegas in 2007 to take this faculty position. While working as faculty in the DPT program here I completed a PhD in Public Health at UNLV in 2014. I’ve been at UNLV ever since.

As a new grad, I joined the intensive care unit at Creighton University Medical Center where I gained valuable clinical experience. The lack of evidence in guiding my actions there propelled me into academia, fueling my passion to enhance the role of physical therapists in hospitals through research. Professionally, I didn’t imagine that I would practice in a hospital like I did. My initial plans were rooted in outpatient neurology, but I ended up getting offered a job by the manager of one of my clinical sites. She asked me to initiate the practice within the intensive care unit of a level one trauma hospital, sensing a need for increased patient engagement. She saw potential in me and said, “I believe you’re the right person for this.”

What made you want to become a PT?

The turning point came during a visit to an Oregon resident with multiple sclerosis. I witnessed a caregiver aiding her transfer from a wheelchair to the floor, and it struck me profoundly. In that moment, it was just like a light bulb turned on and I thought: “I need to be a physical therapist.” While having a father with muscular dystrophy certainly influenced my understanding of physical limitations and mobility challenges, my career choice was not a conscious decision before that time.

Can you tell us a little bit about your professional journey?

After completing my DPT, I found myself in an intensive care unit at a level one trauma hospital in Omaha. I faced resistance from nurses and physicians in the ICU who were hesitant about my involvement in patient care. Convincing them of the benefits of exercise for critically ill patients was challenging due to the lack of evidence at that time. Despite my efforts since joining the university in 2007, the evidence for physical therapy in hospitals remains scarce. After starting in a teaching position, I pursued my Ph.D. in public health and transitioned to a research role in 2014. In 2016, I obtained a research fellowship at Johns Hopkins, focusing on health services research training. This fellowship marked a shift towards my current research collaboration with the team at Johns Hopkins.

What research have you been working on?

Most of my research stems from collaborations with Johns Hopkins and other partnerships that originated from my prior work with them, which served as a significant catalyst for my research career. I’ve been particularly focused on understanding hospitalized patient mobility and activity, a key interest sparked during my time as a physical therapist in a hospital. My goal is to investigate the impact of increased physical therapy during hospitalization on patient outcomes, specifically focusing on their post-hospitalization destination—whether they return home or require further care in a skilled nursing facility or rehab center.

My fellowship and training in Health Services Research at CoHSTAR was a natural extension of my Ph.D. in public health, aligning with my passion for leveraging data available in modern electronic medical record systems. Utilizing medical records data has been a central aspect of my research, delving into the relationships between mobility, physical function, exercise, and outcomes like post-discharge physical function or potential harms from immobility. This approach has been the cornerstone of my research journey since securing a fellowship in 2016, partly funded by the Foundation through CoHSTAR, and continues to guide my work, aiming to better inform future medical practices.

What role did the Foundation play in your research journey?

The Foundation supported my fellowship indirectly through CoHSTAR, providing funding for my 2016-2018 work at Hopkins. Reflecting on the annual report to CoHSTAR, this fellowship significantly fueled my research, resulting in 30+ publications and presentations. The research primarily involved studying hospital medical records, focusing on patient mobility and physical function. We’ve examined how systematic physical function measures relate to patient outcomes like falls, pressure injuries, and discharge destinations. During my fellowship, the beginning in 2016 and provided a 12-month grant this year (2023), specifically investigating the relationship between physical therapy and hospital discharge.

What is the value of physical therapy research to you?

As I mentioned, my main drive to transition from clinical practice to a research career stemmed from the frustration of not having sufficient knowledge about what was necessary for individuals in the hospital. There was a lack of information to guide patients, physicians, and nurses on the best approaches to exercise and rehabilitation for hospitalized individuals. That’s my focus—what I’m working on and what the Foundation is assisting me with. This field remains underexplored, and hospital-based physical therapists continue to grapple with the necessary support to make informed decisions about patient care.

Any final thoughts?

I’d like to emphasize that numerous individuals share the sentiment that, since 2002 when I began practicing, a significant amount of research, especially in critical care units of hospitals, has taken place. However, what has posed a challenge for us as physical therapists is the limited research directed towards the physical therapist’s role. While we understand the importance of early mobility in critical care, we lack clarity on the extent and specific type of mobility that necessitates a physical therapist’s involvement. Additionally, determining which patients require a physical therapist remains uncertain. In the hospital but outside the ICU, we recognize the significance of sustained mobility and activity, but the exact amount and the role of physical therapists in facilitating this for patients remain unknown. There are substantial gaps in our understanding of hospital care that still await thorough investigation.


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