Outcome Assessments! In school we learned hundreds of different outcome measures: Measures for Fear Avoidance, Fall Risk, Disability, Quality of Life, and more. Everyone hears about them, but who actually uses them? According to a study by Jette et al, 48% of therapists used standard outcome measures. Personally, we thought this figure was slightly ambitious, but the even more unfortunate figure was that of the 52% of participants who did not use outcome measures, 49% stated they did not intend to incorporate them into their clinical practice in the future. Reasons for the lack of participation included the measures are too time consuming, too difficult for the patient to fill out individually, and too time consuming to analyze and calculate the results.
While we do not agree with these excuses, we do understand the added workload in using certain Outcome Measures. Let's not focus on why we do not use them, but rather point our attention to why we should incorporate them more regularly. First, they can be an excellent tool to give the practitioner objective data that he/she can utilize in goal setting and prognosis. The assessment will paint a clinical picture of the patient's functional ability and open up communication between the PT and patient to discuss how the patient perceives his/her current status.
Second, payers want to see them! Even if you are not satisfied with using them, CMS for example is "recommending" that patients fill particular outcome measures that directly link to functional limitations. The guidelines with which we get reimbursed are becoming much more stringent. These assessments are an objective means of showing improvement. Whether you like it or not, our field is progressing to a pay-for-outcomes profession. Finally, if we ever expect to gain autonomy in clinical practice, we need to show consistent objective data that our treatments have a true impact on the patient's function. Currently there are several very sophisticated outcome measures, such as FOTO, that give you information about a patient's fear avoidance, expected number of visits, expected improvement, and more. We need to continue to use these measures to standardize practice!
As we mentioned at the beginning, there are hundreds of different outcome assessment to choose from. Memorizing them would not be beneficial. Rather you should know where to find them and how to interpret them. The following are two great resources that give you access to a number of familiar (and some unfamiliar) assessments you are likely to encounter.