How Can We Best Measure our Patients’ Journeys?

Barber Prosthetics Clinic

Fun Facts:

When our patients with lower limb loss are discharged from rehabilitation, the average person can walk 97 m in 2 minutes.  This is almost the length of a soccer field!

When getting a new socket, the average rating for socket comfort is 8.7 on a score where 10 is the most comfortable socket imaginable.  That’s pretty comfortable!

As prosthetists, we aim to provide the highest level of care to help you reach your goals.  However, without measuring your goals and progress, it’s hard to know objectively if we are helping you to achieve them.  While everyone’s goal is different, there are some general things that we can measure to track progress over time. These involve things like comfort, mobility, balance, satisfaction and more.  Outcome measures are one way that we can measure progress over time.  They have been found to provide motivation and encouragement to our patients, facilitate communication with allied health care professionals, aid in clinical decision making, evaluate treatment outcomes and direct goal setting.  However, there are lots of gaps in the knowledge about how to integrate outcome measure successfully into practice and how to interpret the scores in a meaningful way.  We endeavored to help our patients by addressing these gaps.  

In 2015 we started integrating outcome measures into regular clinical practice. We have become leaders in North America on the integration of outcome measures into clinical practice and have given many talks and taught many courses, in-services and seminars on how to do this.  We were surprised with how positively our patients responded to the incorporation of outcome measures in their care and realized that the biggest benefit to using them is the value it gives out patients. 

On the clinical side, we also understand the challenges of using outcome measures and have explored many avenues of addressing these barriers.  While we have been able to share with patients how their scores have changed over time and seen how this data positively impacts their experience, we now have enough data to begin analyzing the larger group to provide better insight on how to interpret scores and changes in them to provide more meaningful feedback to our patients. 

Many of our patients have found outcome measures to be a benefit to their care.  We hear things such as “Everyone needs this encouragement!”, “Objective numbers are very motivating”, “Can I take this home to show my sister?” and “A piece of paper [with these numbers] is power for the patient!”.  Patients can see how their hard work has paid off and how they are making progress towards their goals.  It can also provide valuable information when they are not making progress towards their goals about what is limiting them and other factors at play.  The more we understand about outcome measures and how to interpret the values, the better the patients can understand what these scores mean and be positively impacted by their results.  

The larger community has found this work to be very valuable as well.  We have been invited to talk at conferences across north America on the topic of patients benefits of outcome measures use, integration of outcome measures into clinical practice, and how to interpret outcome measure scores.  We have also run education programs at two other clinics across the country on out model of outcome measure use.  We are also now analyzing the scores as a larger group to provide very valuable information for clinicals, physiotherapists, physicians and more about how to interpret these scores in a meaningful way.  

Resources: For more information about the education program we developed to help other clinics use outcome measures, see our paper here: Attitudes and behaviors toward using outcome measures in cli... : Prosthetics and Orthotics International (lww.com)