Changing the Culture of a Large Multihospital Acute Care Therapy System to Value-Added Through Best Practice Guidelines

Hull, Brian; Thut, M. Catherine; Cheng, Sharon; Kaufhold, Donna M.; Brown, Suzanne Robben

doi:10.1097/jat.0000000000000025

Cited by 4 publications

(8 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The acute care setting accounted for the largest number of included studies ( n = 41, 59%), 27,28,33,34,37,39-42,45,46,48,50,52,53,55,58,59,62,66,68,70-74,76-78,88,89,95-98,100-105 followed by the outpatient setting ( n = 19, 27%). 29-32,36,38,47,49,54,56,60,61,64,67,69,79,80,93,99 Other practice settings included inpatient rehabilitation ( n = 6, 8.6%), 36,43,57,65,75,76 home health ( n = 2, 2.9%), 44,63 other ( n = 2, 2.9%), 19,81 and academia ( n = 2, 2.9%).…”

Section: Resultsmentioning

confidence: 99%

“…Of the 70 total included studies in this review, 18 (26%) 28,37,39,40,43-45,48,52,60,68,70,73,74,77,79,96,102 were approved by local ethics boards, 19 (27%) 32-34,36,41,46,47,49,50,53,55,56,58,63,64,67,81,97,100 sought approval but were considered exempt, 15 (21%) 19,35,38,42,57,59,61,62,65,71,72,75,78,80,93 reported that seeking approval was not necessary at their institution based on the type of project proposed and current regulations, and 18 (26%) 27,29-31,51,54,66,69,76,88,89,95,98,99,101,103-105 made no mention of ethics oversight.…”

Section: Resultsmentioning

confidence: 99%

“…Ten studies (14%) [29][30][31]37,51,75,93,96,100,101 were published in Physical Therapy, whereas five (7.1%) were published in the Journal of Acute Care Physical Therapy. 58,88,89,98,105…”

Section: Number Of Journalsmentioning

confidence: 99%

“…The second most common service level involved QI efforts in orthopedics (n 5 11, 15.7%). 30,31,50,60,61,64,69,70,79,89,99 The service level described as "system" comprised seven studies (10%), 36,37,48,58,81,88,105 and included QI projects related to system processes or outcomes in PT practice that were not specific to a given service level.…”

Section: Service Levelmentioning

confidence: 99%

“…We defined QI models and tools as formal methods applied to structure the intended QI effort. Twentytwo studies (31%) 27,29,30,32,[39][40][41]48,50,60,70,74,79,81,88,89,96,98,99,101,102,105 used none of these to guide their QI effort. The most commonly cited model/tool was Plan-Do-Study-Act cycles (n 5 19, 27%) 35,38,46,52,54,55,57,58,[63][64][65][66]73,75,78,80,93,100,103 followed by the Model for Improvement (N 5 8, 11%).…”

Section: Qi Models or Toolsmentioning

confidence: 99%

See 4 more Smart Citations

The Use of Quality Improvement in the Physical Therapy Literature: A Scoping Review

Crick¹,

Rethorn²,

Beauregard³

et al. 2023

J Healthc Qual

View full text Add to dashboard Cite

Introduction: Quality improvement (QI) is a useful methodology for improving healthcare, often through iterative changes. There is no prior review on the application of QI in physical therapy (PT). Purpose and Relevance: To characterize and evaluate the quality of the QI literature in PT. Methods: We searched four electronic databases from inception through September 1, 2022. Included publications focused on QI and included the practice of PT. Quality was assessed using the 16-point QI Minimum Quality Criteria Set (QI-MQCS) appraisal tool. Results: Seventy studies were included in the review, 60 of which were published since 2014 with most (n = 47) from the United States. Acute care (n = 41) was the most prevalent practice setting. Twenty-two studies (31%) did not use QI models or approaches and only nine studies referenced Revised Standards for QI Reporting Excellence guidelines. The median QI-MQCS score was 12 (range 7–15). Conclusions/Implications: Quality improvement publications in the PT literature are increasing, yet there is a paucity of QI studies pertaining to most practice settings and a lack of rigor in project design and reporting. Many studies were of low-to-moderate quality and did not meet minimum reporting standards. We recommend use of models, frameworks, and reporting guidelines to improve methodologic rigor and reporting.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Ten studies (14%) [29][30][31]37,51,75,93,96,100,101 were published in Physical Therapy, whereas five (7.1%) were published in the Journal of Acute Care Physical Therapy. 58,88,89,98,105…”

Section: Number Of Journalsmentioning

confidence: 99%

Section: Service Levelmentioning

confidence: 99%

Section: Qi Models or Toolsmentioning

confidence: 99%

See 3 more Smart Citations

The Use of Quality Improvement in the Physical Therapy Literature: A Scoping Review

Crick¹,

Rethorn²,

Beauregard³

et al. 2023

J Healthc Qual

View full text Add to dashboard Cite

show abstract

A Simple Tool Using AM-PAC “6-Clicks” to Measure Value Added in Acute Care Physical Therapy: The Therapy Value Quotient

Hull¹,

Thut²

2018

Journal of Acute Care Physical Therapy

View full text Add to dashboard Cite

Background and Purpose: Acute physical therapy practitioners and leaders continue to search for a practical method to measure value. The purpose of this case report is to introduce the Therapy Value Quotient and its simple yet effective use of Activity Measure for Post-Acute Care Inpatient Mobility Short Form, also known as “6-Clicks,” and common payroll data to measure changes in value added to patient care. Case Description: Health care service value should be measured by outcomes produced divided by the cost of services to produce those outcomes. Although acute physical therapy practice continues to progress toward consistent outcome measurement, widespread application of outcomes to quantify value is rare. This lack of value measurement leaves acute care practitioners' value measured primarily in terms of how many units or visits a therapist can code in a certain number of hours worked. Unfortunately, quantities of units or visits are not synonymous with value. Acute care managers and practitioners need a viable and easy-to-use tool that requires minimal data entry and uses existing, easily accessible payroll and electronic health record data. Outcomes: The goal of this project was to create a value calculation with commonly used systems (payroll, electronic health record) data and Activity Measure for Post-Acute Care Inpatient Mobility Short Form data to quantify value. Minimizing manual data entry decreases errors and improves real-time calculations. The purposely minimized design of the equation allows clinicians and managers freedom to create highest-value processes that achieve the maximal value added. Discussion: The Therapy Value Quotient can help managers and clinicians investigate and measure value-adding tactics while improving care delivery and efficiency instead of simply increasing the number of procedures per hour worked.

show abstract

Achieving high-quality care: a view from NICE

Partridge

2017

Heart

View full text Add to dashboard Cite

The National Institute for Health and Care Excellence (NICE) was established in 1999 to provide evidence-based guidance. The task of producing guidance by reviewing primary research data and using an advisory committee to develop evidence-based recommendations, is not straightforward. Guidance production is, however, less challenging than the task of putting evidence-based recommendations into practice.NICE is very sensitive to this challenge as, since 1999, over 1500 pieces of NICE guidance have been published. A number of pieces of guidance relate to heart disease, including pharmaceutical agents, new medical technologies and clinical guidelines. Examples include guidelines on acute heart failure and atrial fibrillation, and advice on technologies including edoxaban and implantable cardioverter defibrillators.The research evidence is clear that a change in practice rarely comes about as a result of simply disseminating guidance on best practice. Simple dissemination is particularly ineffective if the guidance has not been produced by a well-respected, credible organisation. It is also clear from the literature that implementation is more successful when more than one approach is taken, and when there is alignment between efforts at organisational, local and national levels.At an organisational level, there should be support from the Board for quality improvement, with ongoing measurement of progress. Resources should be provided for targeted change programmes, particularly where new guidance suggests improvements are required. A systematic process for putting change in place should include identifying barriers to change, agreeing interventions to overcome the barriers and drive forward improvement and planning for implementation and evaluation.

show abstract

Changing the Culture of a Large Multihospital Acute Care Therapy System to Value-Added Through Best Practice Guidelines

Cited by 4 publications

References 4 publications

The Use of Quality Improvement in the Physical Therapy Literature: A Scoping Review

The Use of Quality Improvement in the Physical Therapy Literature: A Scoping Review

A Simple Tool Using AM-PAC “6-Clicks” to Measure Value Added in Acute Care Physical Therapy: The Therapy Value Quotient

Achieving high-quality care: a view from NICE

Contact Info

Product

Resources

About