A uniform data set for determining outcomes in allied health primary contact services in Australia
Nicole Moretto A B C , Michelle Stute B , Sonia Sam B , Marita Bhagwat B , Maree Raymer B , Peter Buttrum B , Merrilyn Banks B and Tracy A. Comans A BA Centre for Health Services Research, The University of Queensland, Princess Alexandra Hospital campus, Woolloongabba, Qld 4102, Australia.
B Metro North Hospital and Health Service, Royal Brisbane and Women’s Hospital, Butterfield Street, Herston, Qld 4029, Australia.
C Corresponding author: Email: N.Moretto@uq.edu.au
Australian Journal of Primary Health 26(1) 58-69 https://doi.org/10.1071/PY18104
Submitted: 9 July 2018 Accepted: 23 September 2019 Published: 20 January 2020
Abstract
The project aim was to develop and implement a set of metrics to capture and demonstrate the performance of newly established allied health primary contact services. Selection of the metrics and performance indicators was guided by an existing state-wide data collection system and from a review of the published literature. The metrics were refined after consultation with a working group of health service managers and clinicians. The data collection and reporting framework were developed for use in allied health primary contact services and implemented at public health facilities in Queensland, Australia. The set of metrics consists of 18 process and outcome measures. Patient-reported metrics include the global rating of change scale and patient satisfaction. Service metrics include wait times; referral source; triage category; diagnosis; occasions of service; referrals and investigations initiated; effects; care duration; discharge status; waitlist reinstatement reasons; treatment non-completion reasons; and expedited care. Safety, patient demographics and service improvement metrics were included. The metrics will enable analysis of the effectiveness of allied health primary contact services and will facilitate reporting, advocacy, service improvement, service continuity and research. The metrics are suitable for use by all providers of allied health primary contact services in hospital and primary care settings.
Additional keywords: health services research, models of care, performance and evaluation, quality and safety.
References
Allied Health Professions’ Office of Queensland (2014) Ministerial Taskforce on health practitioner expanded scope of practice: final report. Queensland Government, Brisbane, Qld, Australia.Centre for Health Economics (2014) AQoL – Assessment of Quality of Life. (Centre for Health Economics, Monash University: Clayton, Vic., Australia) Available at http://www.aqol.com.au/ [Verified 22 June 2018]
Blackburn MS, Cowan SM, Cary B, Nall C (2009) Physiotherapy-led triage clinic for low back pain. Australian Health Review 33, 663–670.
| Physiotherapy-led triage clinic for low back pain.Crossref | GoogleScholarGoogle Scholar | 20166916PubMed |
Comans TA, Clark MJ, Cartmill L, Ash S, Sheppard LA (2011) How do allied health professionals evaluate new models of care? What are we measuring and why? Journal for Healthcare Quality 33, 19–28.
| How do allied health professionals evaluate new models of care? What are we measuring and why?Crossref | GoogleScholarGoogle Scholar | 21733021PubMed |
Comans T, Raymer M, O’Leary S, Smith D, Scuffham P (2014) Cost-effectiveness of a physiotherapist-led service for orthopaedic outpatients. Journal of Health Services Research & Policy 19, 216–223.
| Cost-effectiveness of a physiotherapist-led service for orthopaedic outpatients.Crossref | GoogleScholarGoogle Scholar |
Comans TA, Chang AT, Standfield L, Knowles D, O’Leary S, Raymer M (2017) The development and practical application of a simulation model to inform musculoskeletal service delivery in an Australian public health service. Operations Research for Health Care 15, 13–18.
| The development and practical application of a simulation model to inform musculoskeletal service delivery in an Australian public health service.Crossref | GoogleScholarGoogle Scholar |
Corbett AM, Francis KL (2006) Participatory action research: a method to improve the management of health service delivery. Australian Journal of Case Management 7, 10–13.
Costa LO, Maher CG, Latimer J, Ferreira PH, Ferreira ML, Pozzi GC, Freitas LM (2008) Clinimetric testing of three self-report outcome measures for low back pain patients in Brazil: which one is the best? Spine 33, 2459–2463.
| Clinimetric testing of three self-report outcome measures for low back pain patients in Brazil: which one is the best?Crossref | GoogleScholarGoogle Scholar | 18923324PubMed |
Desmeules F, Roy J-S, MacDermid JC, Champagne F, Hinse O, Woodhouse LJ (2012) Advanced practice physiotherapy in patients with musculoskeletal disorders: a systematic review. BMC Musculoskeletal Disorders 13, 107
| Advanced practice physiotherapy in patients with musculoskeletal disorders: a systematic review.Crossref | GoogleScholarGoogle Scholar | 22716771PubMed |
Desmeules F, Toliopoulos P, Roy J-S, Woodhouse LJ, Lacelle M, Leroux M, Girard S, Feldman DE, Fernandes JC (2013) Validation of an advanced practice physiotherapy model of care in an orthopaedic outpatient clinic. BMC Musculoskeletal Disorders 14, 162
| Validation of an advanced practice physiotherapy model of care in an orthopaedic outpatient clinic.Crossref | GoogleScholarGoogle Scholar | 23656928PubMed |
Fennelly O, Blake C, Desmeules F, Stokes D, Cunningham C (2018) Patient-reported outcome measures in advanced musculoskeletal physiotherapy practice: a systematic review. Musculoskeletal Care 16, 188–208.
| Patient-reported outcome measures in advanced musculoskeletal physiotherapy practice: a systematic review.Crossref | GoogleScholarGoogle Scholar | 28660673PubMed |
Fischer D, Stewart AL, Bloch DA, Lorig K, Laurent D, Holman H (1999) Capturing the patient’s view of change as a clinical outcome measure. Journal of the American Medical Association 282, 1157–1162.
| Capturing the patient’s view of change as a clinical outcome measure.Crossref | GoogleScholarGoogle Scholar | 10501119PubMed |
Guyatt GH, Norman GR, Juniper EF, Griffith LE (2002) A critical look at transition ratings. Journal of Clinical Epidemiology 55, 900–908.
| A critical look at transition ratings.Crossref | GoogleScholarGoogle Scholar | 12393078PubMed |
Hawthorne G, Osborne R (2005) Population norms and meaningful differences for the Assessment of Quality of Life (AQoL) measure. Australian and New Zealand Journal of Public Health 29, 136–142.
| Population norms and meaningful differences for the Assessment of Quality of Life (AQoL) measure.Crossref | GoogleScholarGoogle Scholar | 15915617PubMed |
Hawthorne G, Richardson J, Day NA (2001) A comparison of the Assessment of Quality of Life (AQoL) with four other generic utility instruments. Annals of Medicine 33, 358–370.
| A comparison of the Assessment of Quality of Life (AQoL) with four other generic utility instruments.Crossref | GoogleScholarGoogle Scholar | 11491195PubMed |
Hollingsworth B (2008) The measurement of efficiency and productivity of health care delivery. Health Economics 17, 1107–1128.
| The measurement of efficiency and productivity of health care delivery.Crossref | GoogleScholarGoogle Scholar | 18702091PubMed |
Homeming LJ, Kuipers P, Nihal A (2012) Orthopaedic podiatry triage: process outcomes of a skill mix initiative. Australian Health Review 36, 457–460.
| Orthopaedic podiatry triage: process outcomes of a skill mix initiative.Crossref | GoogleScholarGoogle Scholar | 22959039PubMed |
Jones J, Hunter D (1995) Consensus methods for medical and health services research. BMJ (Clinical Research Ed.) 311, 376–380.
| Consensus methods for medical and health services research.Crossref | GoogleScholarGoogle Scholar |
Kamper SJ, Maher CG, Mackay G (2009) Global rating of change scales: a review of strengths and weaknesses and considerations for design. The Journal of Manual & Manipulative Therapy 17, 163–170.
| Global rating of change scales: a review of strengths and weaknesses and considerations for design.Crossref | GoogleScholarGoogle Scholar |
Kasbekar AV, Mullin N, Morrow C, Youssef AM, Kay T, Lesser TH (2014) Development of a physiotherapy-led balance clinic: the Aintree model. The Journal of Laryngology and Otology 128, 966–971.
| Development of a physiotherapy-led balance clinic: the Aintree model.Crossref | GoogleScholarGoogle Scholar | 25311108PubMed |
Lilje SC, Persson UB, Tangen ST, Kasamoen S, Skillgate E (2014) Costs and utilities of manual therapy and orthopedic standard care for low-prioritized orthopedic outpatients of working age: a cost consequence analysis. The Clinical Journal of Pain 30, 730–736.
| Costs and utilities of manual therapy and orthopedic standard care for low-prioritized orthopedic outpatients of working age: a cost consequence analysis.Crossref | GoogleScholarGoogle Scholar | 24042345PubMed |
Meehan T, McCombes S, Hatzipetrou L, Catchpoole R (2006) Introduction of routine outcome measures: staff reactions and issues for consideration. Journal of Psychiatric and Mental Health Nursing 13, 581–587.
| Introduction of routine outcome measures: staff reactions and issues for consideration.Crossref | GoogleScholarGoogle Scholar | 16965478PubMed |
Murphy S, Blake C, Power CK, Fullen BM (2013) The role of clinical specialist physiotherapists in the management of low back pain in a spinal triage clinic. Irish Journal of Medical Science 182, 643–650.
| The role of clinical specialist physiotherapists in the management of low back pain in a spinal triage clinic.Crossref | GoogleScholarGoogle Scholar | 23564519PubMed |
National Cancer Institute (2010) Common terminology criteria for adverse events (CTCAE). Version 4.0. US Department of Health and Human Services, National Institutes of Health, National Cancer Institute, Bethesda, MD, USA.
National Cancer Institute (2017) Common terminology criteria for adverse events (CTCAE). Version 5.0. US Department of Health and Human Services, National Institutes of Health, National Cancer Institute, Bethesda, MD, USA.
O’Brien L, Hardman A, Goldby S (2013) The impact of a hand therapy screening and management clinic for patients referred for surgical opinion in an Australian public hospital. Journal of Hand Therapy 26, 318–322, quiz 322.
| The impact of a hand therapy screening and management clinic for patients referred for surgical opinion in an Australian public hospital.Crossref | GoogleScholarGoogle Scholar | 23919924PubMed |
Porter ME (2010) What is value in health care? (Appendix 2: Measuring health outcomes: the outcomes hierarchy). The New England Journal of Medicine 363, 2477–2481.
| What is value in health care? (Appendix 2: Measuring health outcomes: the outcomes hierarchy).Crossref | GoogleScholarGoogle Scholar | 21142528PubMed |
Porter ME, Larsson S, Lee TH (2016) Standardizing patient outcomes measurement. The New England Journal of Medicine 374, 504–506.
| Standardizing patient outcomes measurement.Crossref | GoogleScholarGoogle Scholar | 26863351PubMed |
Prinsen CAC, Vohra S, Rose MR, Boers M, Tugwell P, Clarke M, Williamson PR, Terwee CB (2016) How to select outcome measurement instruments for outcomes included in a “Core Outcome Set” – a practical guideline. Trials 17, 449
| How to select outcome measurement instruments for outcomes included in a “Core Outcome Set” – a practical guideline.Crossref | GoogleScholarGoogle Scholar |
Queensland Government (2013) Blueprint for better healthcare in Queensland – February 2013. State of Queensland (Queensland Health), Brisbane, Qld, Australia.
Raymer M (2017) Neurosurgical and orthopaedic physiotherapy screening clinics (N/OPSC). Neurosurgical and orthopaedic physiotherapy screening clinics (N/OPSC) Forum. Metro North Hospital and Health Service, Brisbane, Qld, Australia.
Richardson J (2010) Psychometric Validity and Multi Attribute Utility (MAU) Instruments. Monash University, Vic., Australia.
Richardson J, Iezzi A, Khan MA, Maxwell A (2014) Validity and reliability of the Assessment of Quality of Life (AQoL)-8D multi-attribute utility instrument. Patient 7, 85–96.
| Validity and reliability of the Assessment of Quality of Life (AQoL)-8D multi-attribute utility instrument.Crossref | GoogleScholarGoogle Scholar | 24271592PubMed |
Standfield L, Comans T, Raymer M, O’Leary S, Moretto N, Scuffham P (2016) The efficiency of increasing the capacity of physiotherapy screening clinics or traditional medical services to address unmet demand in orthopaedic outpatients: a practical application of discrete event simulation with dynamic queuing. Applied Health Economics and Health Policy 14, 479–491.
| The efficiency of increasing the capacity of physiotherapy screening clinics or traditional medical services to address unmet demand in orthopaedic outpatients: a practical application of discrete event simulation with dynamic queuing.Crossref | GoogleScholarGoogle Scholar | 27116359PubMed |
Stewart M, Maher CG, Refshauge KM, Bogduk N, Nicholas M (2007) Responsiveness of pain and disability measures for chronic whiplash. Spine 32, 580–585.
| Responsiveness of pain and disability measures for chronic whiplash.Crossref | GoogleScholarGoogle Scholar | 17334294PubMed |
Stratford PW, Binkley J, Solomon P, Gill C, Finch E (1994) Assessing change over time in patients with low back pain. Physical Therapy 74, 528–533.
| Assessing change over time in patients with low back pain.Crossref | GoogleScholarGoogle Scholar | 8197239PubMed |
Stute M, Moretto N, Raymer M, Banks M, Buttrum P, Sam S, Bhagwat M, Comans T (2018) Process to establish 11 primary contact allied health pathways in a public health service. Australian Health Review 42, 258–265.
| Process to establish 11 primary contact allied health pathways in a public health service.Crossref | GoogleScholarGoogle Scholar | 28483033PubMed |
Thompson J, Yoward S, Dawson P (2017) The role of physiotherapy extended scope practitioners in musculoskeletal care with focus on decision making and clinical outcomes: a systematic review of quantitative and qualitative research. Musculoskeletal Care 15, 91–103.
| The role of physiotherapy extended scope practitioners in musculoskeletal care with focus on decision making and clinical outcomes: a systematic review of quantitative and qualitative research.Crossref | GoogleScholarGoogle Scholar | 27329328PubMed |
van den Berg B, Gafni A, Portrait F (2017) Attributing a monetary value to patients’ time: a contingent valuation approach. Social Science & Medicine 179, 182–190.
| Attributing a monetary value to patients’ time: a contingent valuation approach.Crossref | GoogleScholarGoogle Scholar |
van der Roer N, Ostelo RW, Bekkering GE, van Tulder MW, de Vet HC (2006) Minimal clinically important change for pain intensity, functional status, and general health status in patients with nonspecific low back pain. Spine 31, 578–582.
| Minimal clinically important change for pain intensity, functional status, and general health status in patients with nonspecific low back pain.Crossref | GoogleScholarGoogle Scholar | 16508555PubMed |
Watson CJ, Propps M, Ratner J, Zeigler DL, Horton P, Smith SS (2005) Reliability and responsiveness of the lower extremity functional scale and the anterior knee pain scale in patients with anterior knee pain. The Journal of Orthopaedic and Sports Physical Therapy 35, 136–146.
| Reliability and responsiveness of the lower extremity functional scale and the anterior knee pain scale in patients with anterior knee pain.Crossref | GoogleScholarGoogle Scholar | 15839307PubMed |
Williams K, Sansoni J, Morris D, Grootemaat P, Thompson C (2016) Patient-reported outcome measures: literature review. Australian Commission on Safety and Quality in Health Care, Sydney, NSW, Australia.
Wood L, Hendrick P, Boszczyk B, Dunstan E (2016) A review of the surgical conversion rate and independent management of spinal extended scope practitioners in a secondary care setting. Annals of the Royal College of Surgeons of England 98, 187–191.
| A review of the surgical conversion rate and independent management of spinal extended scope practitioners in a secondary care setting.Crossref | GoogleScholarGoogle Scholar | 26741663PubMed |