Measuring & Improving the Delivery of Patient Care

Welcome, and congratulations! The fact that you are here shows that you are dedicated to providing your patients with the very best experience in physical therapy. Let’s dive right into this five-step guide to improving quality of care as a new grad – here’s your checklist

  • Prioritize patient safety
  • Document thoroughly
  • Actually analyze your outcome measures
  • Track patient satisfaction and loyalty
  • Take advantage of health technology

Put Safety First

While the well-known phrase, “first, do no harm”, is perhaps worthy of some critique in the modern era, it holds within it a kernel of truth. (1) As healthcare providers, physical therapists must strive to strike a balance between helping their patients improve to the fullest extent possible and avoiding overzealous treatment that could cause more harm than good.

At key clinical decision points, ask yourself: Is the risk of an adverse event worth the possible benefit my patient could receive from this intervention?

In a recent viewpoint article, Eversole and colleagues posit that the quality of care provided in physical therapy can be measured in three distinct domains: clinical effectiveness, safety, and patient experience. (2) As a key pillar of quality PT practice, safety must be paramount in every interaction between patient and therapist.

If You Didn’t Document It, It Didn’t Happen

Your PT school professors weren’t kidding: complete, clear documentation is as critical to quality patient care as the interventions you provide. You’ve already been taught the importance of defensible documentation that will stand up to scrutiny in a court of law.

However, your charting also directly affects your patients and the care they receive. Thorough documentation:

  • Helps you track which interventions worked well and which didn’t
  • Insures a smooth transfer of patients to/from other providers
  • Prevents delays in care caused by insurance claims denial

Between productivity demands and complex patient cases, it’s normal to feel overwhelmed by the day-to-day demands of your first job as a new grad. This is where your notes come in: the more details you include in your daily treatment notes, the better you’ll be able to keep track of which techniques are working for your patients and which ones aren’t worth continuing.

If you’ve already had the opportunity to cover patients for a coworker on vacation or leave, then you can further appreciate the importance of clear charting. There’s nothing like trying to interpret another therapist’s hand-drawn stick figures and scribbled sets/reps prescription in the margins to make you throw up your hands in frustration.

Don’t be that therapist: keep your notes and patient education materials orderly, concise, and clear so that anyone covering for you can follow your plan of care without disrupting your patients’ experience.

The AC Health app can help with this! The app allows you to record the exact parameters of the exercises you’d like your patients to be performing, so you’ll never have to worry if your HEP documentation is correct.

Finally, good documentation makes it much harder for insurance companies to deny claims for a failure to demonstrate medical necessity. There’s nothing more frustrating for you or your patients than having to put therapy on hold while waiting for insurance to review and authorize subsequent visits – do the work up front to avoid interruptions down the line.

Numbers Don’t Lie: Outcome Measure Analysis

It’s no secret that value-based healthcare is here to stay: payors and patients alike are demanding evidence that the care provided is worth the cost. (3) One clear way to demonstrate your value as a clinician is through your outcomes data.

Patient-reported outcome measures like the Oswestry Disability Index and the QuickDASH weren’t created just to satisfy insurance companies: they can be a minefield of data for therapists looking to track patient progress. Take the time to actually check your patient’s scores on each outcome measure they complete and compare their scores across their episode of care.

If your clinic uses the FOTO Patient Outcomes system, make use of its wealth of information: it tracks your data over time across all patients with a specific condition so you can see trends: are you getting better at managing patients with acute back pain? Do you need to sharpen your skills for treating those with chronic shoulder pain? This is a powerful way to address the “clinical effectiveness” domain of Eversole’s formula for quality care. (2)

Happy Patients Get Better

When it comes to client satisfaction, PTs should take their lead from the business world: businesses are constantly tracking the satisfaction and loyalty of their customers with metrics like the Net Promotor Score (NPS). (4) Satisfied, loyal patients are the ones who have had a stellar experience as clients of your practice, and as we’ve discussed, the patient experience is a key domain of quality care. (2)

Additionally, happier patients may actually have better clinical outcomes: dissatisfied patients generally attend fewer outpatient PT visits than satisfied ones, and patients who don’t participate therapy aren’t likely to benefit from it. (5)

There’s an app for that!

We’ve saved the best for last: leveraging technology to improve the patient experience and the care you provide. Some basic forms of health tech such as electronic medical records are so ubiquitous now that you may take them for granted, but they can significantly streamline the way you deliver care – provided you’re using them to their full potential.

In addition to making full use of pre-existing health tech in your clinic, you can level up your patient care by integrating new technologies, like smartphone activity trackers and patient engagement apps. (link to top 10 pt engagement apps piece).

The AC Health app is a perfect example of how tech can improve the experience of patient and provider alike: it saves you time by simplifying the HEP creation process, and it allows you to motivate your patients with encouraging messages and a calendar to track their HEP performance.

We hope you you’ve found this quick guide to improving patient care valuable – create your free account today to learn how AC Health can help you increase clinical effectiveness and improve your patients’ experience in physical therapy!

References

1. Shmerling, R. (2020, June 22). First, do no harm. Harvard Health. https://www.health.harvard.edu/blog/first-do-no-harm-201510138421
2. Eversole, J., Grimm, A., Patel, N., John, K., & Garcia, A. N. (2021). Why Measure Patient Experience in Physical Therapy? Archives of Physiotherapy, 11(1). https://doi.org/10.1186/s40945-021-00105-2
3. Jewell, D. V., Moore, J. D., & Goldstein, M. S. (2013). Delivering the Physical Therapy Value Proposition: A Call to Action. Physical Therapy, 93(1), 104–114. https://doi.org/10.2522/ptj.20120175
4. Jannenga, H. (2020, October 14). Founder Letter: Ask and You Shall Perceive: Why Every Rehab Therapist Must Track NPS. WebPT. https://www.webpt.com/blog/founder-letter-ask-and-you-shall-perceive-why-every-rehab-therapist-must-track-nps/
5. Klepps, R. (2020, September 8). NPS® in Health Care: Leveraging Loyal Patients to Drive New Business and Improve Revenue. WebPT. https://www.webpt.com/blog/nps-in-health-care-leveraging-loyal-patients-to-drive-new-business-and-improve-revenue/