Enhancing Quality of Prosthetic and Orthotic Services with Process and Outcome Information

A. Heinemann, PhD, and L. Ehrlich-Jones, PhD, Co-Project Leaders

Project Manager:
L. Connelly

Consultants:
M. Brncick, Northwestern University Prosthetics-Orthotics Center (NUPOC)
D. Hart, Focus on Therapeutic Outcomes (FOTO)
C. Carter, American Board for Certification in Prosthetics, Orthotics and Pedorthics (ABC)

Funded by: National Institute on Disability and Rehabilitation Research (NIDRR)

Status: In Progress

Introduction

Despite the availability of standard measures to assess functional status, quality of life and satisfaction with services and devices, provider enthusiasm for routine outcomes monitoring and improvement is diminished by the time and expense. We propose to work with the American Board for Certification in Prosthetics, Orthotics and Pedorthics (ABC) and Focus on Therapeutic Outcomes (FOTO) to develop an outcomes monitoring, data collection and reporting service and education program that gives providers the information they need to improve patient care quality. We will work with FOTO to develop a scannable paper and Web-based data entry system that provides secure and confidential outcomes information to ABC-accredited programs. We will evaluate the utility of this system and a quality improvement education curriculum developed in collaboration with NUPOC in terms of the actions providers take to enhance the quality of their patient outcomes.

The ABC accreditation standards are designed to enhance quality healthcare in P&O practices and to help increase efficiency and support initiatives that improve patient outcomes. Facility accreditation helps ABC achieve specific goals including promoting the welfare of persons with disabilities by establishing standards for those engaged in the fitting of prostheses and orthoses. ABC defines six categories of standards including quality assessment and improvement. We have learned from providers that they perceive outcomes data collection and monitoring as time consuming and expensive. While they acknowledge the value of data collection, they do not have access to data management systems that allows them to compare their patient outcomes with other providers. We hypothesize that compliance with ABC’s Performance Management and Improvement Standards related to use of quality indicators will improve from baseline through a three-year implementation process.

Purpose/Specific Objectives 

(1) Develop a database of process and outcome indicators that are useful in guiding clinical
     practice improvement activities;

(2) Develop an educational curriculum that enhances clinicians’ ability to integrate process and 
     outcome information in improving P&O care delivery quality;

(3) Analyze facility compliance with ABC’s Performance Management and
     Improvement Standards;

(4) Evaluate and refine the curriculum on use of quality indicators to improve clinical
     practice and outcomes.

Clinical Implications

This project has the potential to improve clinical practice favorably. The Centers for Medicare and Medicaid Services (CMS) requires facilities to achieve accreditation in order to be eligible for Medicare reimbursement. Still, wide variations in performance management exist, in part because facilities have few examples of how to monitor and improve their services. This project has the potential to develop and promote “best practices” to a wide audience.

Related Presentations and Publications

Heinemann A. Ehrlich-Jones L, Connelly L, Fatone S. Enhancing Quality of Prosthetic and Orthotic Services with Process and Outcome Information. in 38th American Academy of Orthotists and Prosthetists Annual Meeting and Scientific Symposium. March 21-24, 2012. Atlanta GA.

Connelly L, Heinemann A, Ehrlich-Jones L. Enhancing Quality of Prosthetic and Orthotic Services with Process and Outcome Information.  Midwest Chapter of the American Academy of Orthotists and Prosthetists; June 3-4, 2011; Grand Geneva Resort, WI.

Heinemann A, Ehrlich-Jones L, Williams D. Enhancing Quality of Prosthetic Services with Process and Outcome Information. Paper presented at: 13th ISPO World Congress; May 10-15, 2010; Leipzig, Germany.