The first presentation I attended on Friday was called A Clinical Practice Guideline: A Core Set of Outcome Measures for Neurologic Rehabilitation presented by Jennifer Moore, Kirsten Potter and Jane Sullivan.
I chose to attend this lecture after attending the value presentation the day before. The presenters there had mentioned that this upcoming session on outcome measures was also going to play a vital role in their own topic. The value people were recommending using 2-3 outcome measures in EVERY case– 1 general, 1 diagnosis specific and trying to get one each of the 3 ICF domains to demonstrate difficulties with body structure and function, activity and participation. Remember this little graph?:
So in the current session on outcome measures, the presenters are discussing their research in trying to determine what outcome measures to include in the basic neuro toolbox– what “core set” of outcome measures can be used with any diagnosis across any therapy setting? That is a tall question to ask and their hard work proved it.
First, they had to ask therapists and patients too what KIND of outcomes were the most important to them. They identified balance, gait, transfers, and patient stated goals as the items most tested for with outcome measures in neurologic physical therapy. They also found several things about outcome measures that I found… unsettling.
1) In 56% of those questioned, only performance tests were used, no self-reports. We’re missing some valuable information here! Like I mentioned in the previous post, we can easily train our front office staff to administer paper and pencil self-report tests. We need to use some more of those.
2) The therapists explained how the test was used to inform decision making in the plan of care in 50-53% of patients’ experiences. Oh, ya’ll, as my elementary school choir teacher was fond of saying, “Open your mouth!” We know what we’re doing with these tests, we just need to open our mouths and tell our patients! How embarrassing.
3) 37% of the patients were very satisfied with the information they received from the test. If we don’t tell them what we’re doing with the test, how can the patient be satisfied that the tests have added something to their plan of care and weren’t just a waste of everyone’s time? Once again, OPEN YOUR MOUTH!
They pulled out the outcome measures mentioned in all the EDGE Taskforces of each of the main neurologic physical therapy diagnoses and delved into their metrics. They picked out the ones that again could be used in ALL settings as well. And they came up with what I’d call the Toolbox: the outcome measures you should do on every neuro patient that comes through your case load. And they were…
I can’t tell you that. Awwwww! Anti-climatic, I know.
Their research is due to be published as a CPG shortly in the Journal of Neurologic Physical Therapy. I will certainly pass that on here when it does become publicly available.
This is why you’ve got to go to these conferences yourself! So you can have the latest and greatest information at your fingertips and put it into practice before anyone else.
But do know this research is out there and it’s coming down the pipes. What we need to do with this information is use it! We need to apply these Toolbox outcome measures with every patient, every time and we need to OPEN OUR MOUTHS with our patients and explain what we’re doing with them. Sheesh.