Evidence-Based Practice Implementation: Case Report of the Evolution of a Quality Improvement Program in a Multicenter Physical Therapy Organization

Joel M. Stevans; Christopher G. Bise; John C. McGee; Debora L. Miller; Paul Rockar; Anthony Delitto

doi:10.2522/ptj.20130541

Figures

Figure 2.

Minimum data set (MDS) submission compliance. Blue bars indicate submitted MDS; orange bars indicate complete MDS.

Figure 3.

Low back management protocol adherence—October 2007–July 2009. Blue bars represent percentage protocol adherent (n); orange bars represent percentage protocol nonadherent (n).

Appendix 1.

University of Pittsburgh Medical Center (UPMC) Centers for Rehab Services Low Back Pain Minimum Data Set (MDS) Form^a

^a PT=physical therapist, DOB=date of birth, LBP=low back pain, N/A=not applicable, FABQ=Fear-Avoidance Beliefs Questionnaire, FABQ–PA=Fear-Avoidance Beliefs Questionnaire–physical activity subscale, FABQ–W=Fear-Avoidance Beliefs Questionnaire–work subscale, Avg SLR=average straight leg raise, ROM=range of motion, NMES=neuromuscular electrical stimulation. This document is property of UPMC Centers for Rehab Services and may not be reproduced without expressed written consent (05/12).

Figure 1.

Iterative cycle of implementation. Adapted with permission of John Wiley & Sons Inc from: Graham ID, Logan J, Harrison MB, et al. Lost in knowledge translation: time for a map? J Contin Educ Health Prof. 2006;26:13–24.

Tables

Table.

Mean Total Health Care, Physical Therapy, and Patient Out-of-Pocket Costs per Episode of Care^{^a} Based on Low Back Quality Initiative Management Protocol Adherence

↵^a An episode of care was defined as the time from the initial physical therapy evaluation to the last physical therapy visit. If there were no physical therapy visits for >60 days from the last visit, the episode of care was considered complete. Low back pain management costs were captured for 18 months from the start date of a complete episode of care.
^b Total payer costs were defined as all allowed medical, physical therapy, and prescription expenditures paid by the health plan for low back pain management.
^c A 4% discount rate adjustment was applied to all expenditures to account for market inflation.
^d No significance observed (P<.05).
^e All comparisons made with cost data transformed by [log (10)].
^f Total member costs were defined as all allowed medical, physical therapy, and prescription expenditures paid by the member for low back pain management.
^g Total physical therapy costs were defined as all allowed physical therapy expenditures paid by the health plan for low back pain management.
^h Physical therapy member costs were defined as all allowed physical therapy expenditures paid by the member for low back pain management.
ⁱ 95% CI=95% confidence interval.