Using clinical outcomes to identify expert physical therapists.

BACKGROUND AND PURPOSE: Previous studies of expert physical therapists have sampled therapists based on years of clinical experience or reputation, not on their patients' clinical outcomes. The purposes of this study were to identify expert physical therapists by using patient self-reported outcomes...

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Publicado en:Physical Therapy Vol. 83; no. 11; pp. 990 - 1003
Autores principales: Resnik L, Hart DL
Formato: research tables/charts Journal Article
Publicado: Oxford University Press / USA Nov2003
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Oxford University Press / USA
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        atl: Using clinical outcomes to identify expert physical therapists.
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          Resnik L
          Hart DL
        affil: Postdoctoral Fellow, Center for Gerontology and Health Care Research, Brown University, 2 Stimson Ave, Providence, RI 02912; linda_resnik@brown.edu
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        subj:
          Low Back Pain Rehabilitation
          Physical Therapy
          Outcome Assessment
          Quality of Health Care
          Clinical Competence
          Physical Therapists
          Expert Clinicians
          Clinical Assessment Tools
          Quality of Life
          Retrospective Design
          Effect Size
          T-Tests
          Chi Square Test
          Secondary Analysis
          Convenience Sample
          Adolescence
          Adult
          Middle Age
          Aged
          Aged, 80 and Over
          Female
          Male
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          Adolescent: 13-18 years
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Female
          Male
      ab: BACKGROUND AND PURPOSE: Previous studies of expert physical therapists have sampled therapists based on years of clinical experience or reputation, not on their patients' clinical outcomes. The purposes of this study were to identify expert physical therapists by using patient self-reported outcomes and to describe the characteristics of clinicians whose patients with lumbar spine syndromes reported higher health-related quality of life (HRQL) following rehabilitation. METHODS: Retrospective data were analyzed on 24276 patients (mean age=47.8 years, SD=16, range=14-97) with lumbar spine syndromes treated by 930 physical therapists participating in the Focus On Therapeutic Outcomes database in 1999-2000. Physical therapists and staff answered questions concerning years of experience and practice setting when starting their participation in the outcomes system. Patient self-report HRQL data were collected at intake and discharge from outpatient rehabilitation. Discharge HRQL data were risk adjusted using patient characteristics. Data were aggregated by physical therapist. Risk-adjusted discharge HRQL scores were used to classify physical therapists whose patients reported mean HRQL improvement above the 90th percentile as experts and physical therapists whose patients reported mean HRQL improvement between the 45th and 55th percentiles as average. RESULTS: Therapists classified as expert had fewer patients in the database than did therapists classified as average (mean SD) (19 +/-17 versus 29 +/-22). Mean treatment duration was different between groups (32 +/- 11 days for the expert group versus 31+/-8 days for the average group). DISCUSSION AND CONCLUSION: The results challenge assumptions that extensive clinical experience is necessary to achieve superior patient outcomes, and they provide information about the relationship between therapist characteristics and patient outcomes.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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