In this paper, we will focus on comparing the outcome measures to evaluate our practice better. We will also discuss the ways the outcome measures might draw the concept of a perfect injury preventing system nearer, and we will also mention what the introduction of the Electronic medical records has changed in this regard.
- What is outcome measurement?
- What are the significant issues that interfere with the process of searching for and utilizing the data collecting tools?
- What do we have to do to reduce the number of sports injuries that occur every year?
- What factors define the effectiveness of a tool and the completeness of an outcome in the medical environment?
Outcome Measures Methodology
First of all, what is the outcome measurement? “An outcome is the intended goal of an intervention, usually stated as the achievement of or a change in the level of performance in something” (Wade 870). As for measurement, according to Wade, it is “the collection and quantification of a set of data items” (870). Providing outcome measurements relies on two main factors: defining the purpose of treatment and estimating what data are needed for the measurement.
Specific tools that collect data needed for this research are necessary. The basic requirements for such tools usually are the ability to maintain focus on the needed data search; the ability to ignore irrelevant data along the way; the ability to balance the found notions out without biasing towards the extremes. To select the adequate data collection tools, a detailed evaluation process is needed.
Given these requirements, it is obvious that finding fitting tools is not always easy. What are the significant issues that interfere with the process of searching for and utilizing the data collecting tools?
On the one hand, it often happens that the data are either insufficient or incorrect. If we talk about questionnaires and paper forms, the answers from patients might be written unclearly or look obscure. To avoid or solve these issues, the data measuring tools should be understandable and not too time-consuming: exclude complex graphs and charts; exclude long tasks; present the tool as similarly relevant to the assessor and the patient, etc.
On the other hand, there is a problem with the cost of data collecting. Data gathering and implementation should not exceed the expected benefit. It is the job of the professional medical staff to do the gathering as well as the analysis and implementation. However, the data they collect might not always be useful, so data gathering by patients or non-professionals is sometimes much more preferable as it is risk-decreasing and less costly.
Improving Service Quality through Outcome Measures
What do we have to do to reduce the number of sports injuries that occur every year? Is monitoring the improvements a potent way? To answer these questions, first, we will have to list the number of sports injuries that occur every year using specific tools and practices. After this, to understand which tool or practice is the most effective, we have to monitor each one individually as an isolated case.
For example, if we spread awareness about the ways to prevent injury during athletic activities in the form of PSAs on radio and television, what kind of effect would it have on the general public? Similarly, if, for example, we spread information that stretching before participation in competitive, recreational or other sports-related activities helps to relieve muscle stress, we will have to estimate the resulting outcomes according to our study’s goals. Let us say we make the announcements run for half a year. In these announcements, it will be said that there is a variety of different methods of stretching fit for different parts of the body and certain kinds of athletic exercises (American College of Sports Medicine 983).
We can monitor results after that. While the annual amount of sports injuries might not be prevented drastically, this awareness will still improve on “risk management and epidemiological control models” and address problems similar to sports injury prevention and treatment (Andersson and Menckel 761)
Additionally, after this experiment, we can run another set of announcements that say that this mode of injury prevention cannot become the ultimate one as some researchers argue that there is “little evidence that is stretching pre- or post participation prevents injury” (Thacker et al. 375), and many even claim that it negatively affects the athletic performance (Wedderkopp et al. 41-47). We will monitor the way the results of our previous study change after that.
“Trying new solutions to problems and monitoring the results of the new approaches is the essence of performance improvement” (Forman and Nagy 97). Achieving these outcomes means proving the tools and practices effective. What factors define the effectiveness of a tool and the completeness of an outcome in the medical environment? There are special indicators that help determine whether or not a desirable outcome has been achieved, which include client’s engagement, client feedback concerning the services, client’s attendance rates, client’s convenience (e.g. easy transportation from one facility to another), and client’s overall satisfaction with the services (Forman and Nagy 98).
The Standardized Outcome Measures and EMR
The outcome measures do not always work similarly in different settings since the goals of rehabilitation may differ depending on a case or medical facility. It is only logical that the data needed would be different every time. Home care therapists with clinical specialities tend to use standardized outcome measures almost ten times more often than therapists who work in outpatient settings. According to the Journal of the American Physical Therapy Association report “Use of Standardized Outcome Measures in Physical Therapist Practice: Perceptions and Applications”, over 50% of the questioned therapists stated that they never did nor were intending to implement standardized outcome measures in their work (Jette et al. 130).
A small amount of the respondents assumed that they would consider using the measures in the future. The highest rank of using the standardized measures outcome was among the therapists who treated patients with orthopedic conditions. Many admitted that finding appropriate measures for patients with fluctuating conditions might not be easy, especially if they lack proper equipment is the case.
The standardized outcome measures are not too popular with the medical community yet, but they are used one way or another. What are the most frequently used measures that are employable in the treatment of orthopedic cases? Oswestry Low Back Disability Index (ODI) experiences a lot of attention from the therapists around the world, including Australia and Europe, with the highest use rate in Ireland (more than 10% of all the medical facilities).
“Home-grown” measures are also used unexpectedly widely (therapists preferring departmentally developed instruments), even though this practice might be slightly inferior to the others like Lower Extremity Functional Scale (LEFS) and Disabilities of the Arm, Shoulder, and Hand (DASH). 68% of those who implemented standardized outcome measures reported that “validity and reliability” were the key factors in choosing a practice (Jette et al. 132).
Since we use the Electronic medical record (EMR) to collect more measurements in a standardized way now, we can enjoy the benefits of tracking data over time, identifying patients in need of preventive check-ups, monitoring patients’ reactions to changing conditions (e.g., vaccinations, blood pressure readings). It does improve the quality of medical services.
How this Work Would Extend the Existing Literature
I believe this work will have a somewhat significant influence on existing medical literature as it offers the strategies of alarming patients about sports injuries, including ACL-related injuries that require immediate surgical interference to avoid knee osteoarthritis (Paterno et al. 67). Reducing the possibility of athletes suffering these injuries will demand repeated meniscus injuries prevention (Holt, Holt, and Pelhan 170). The outline is as follows:
- Explore the information given in this work thoroughly;
- Implement it accordingly;
- Monitor the results, draw conclusions, correct the errors, and do the whole procedure over with better results.
Our studies cannot provide us with safe injury preventing techniques just yet. The use of the standardized outcome measures may bring this possibility nearer, but, unfortunately, it will not warrant instant results (Lett, Kobusingye, and Sethi 200). We have to be patient to see the improvements in the quality of medical services happen.
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Forman, Robert F., and Paul D. Nagy. Substance Abuse. Rockville, Maryland: U.S. Dept. of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment, 2006. Print.
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Jette, Diane U., James Halbert, Courtney Iverson, Erin Miceli, and Palak Shah. “Use Of Standardized Outcome Measures In Physical Therapist Practice: Perceptions And Applications.” Physical Therapy 89.2 (2008): 125-135. Print.
Lett, Ronald, Olive Kobusingye, and Dinesh Sethi. “A Unified Framework for Injury Control: the Public Health Approach and Haddon’s Matrix Combined.” Injury Control and Safety Promotion 9.3 (2002): 199-205. Print.
Paterno, Mark V., Mitchell Rauh, Laura C. Schmitt, Kevin R. Ford, and Timothy E. Hewett. “Incidence Of Second Anterior Cruciate Ligament (ACL) Injury 2 Years After Primary ACL Reconstruction And Return To Sport.” Orthopaedic Journal of Sports Medicine 1.4 (2013): 67-73. Print.
Thacker, Stephen B., Julie Gilchrist, Donna F. Stroup, and C. Dexter Kimsey, Jr. “The Impact of Stretching On Sports Injury Risk: A Systematic Review Of The Literature.” Medicine & Science in Sports & Exercise 36.3 (2004): 371-378. Print.
Wade, Derick. “Editorial: Generic Or Global Outcome Measures In Rehabilitation: Are They Appropriate For Measuring (And Improving) Service Quality?” Clinical Rehabilitation 23.10 (2009): 867-872. Print.
Wedderkopp, Niels, M. Kaltoft, Bjarne Lundgaard, M. Rosendahl, and Karsten Froberg. “Prevention of Injuries in Young Female Players in European Team Handball. A Prospective Intervention Study.” Medicine & Science in Sports 9.1 (1999): 41-47. Print.