Data and Patient Care

Does a Focus on Data Diminish the Heart of Patient Care?

That is a loaded question, for sure.  To explore the thought, ask yourself if the provision of O&P care is a clinical intervention or a trade skill.  I have noticed that the terms are often used interchangeably.  Another word pair often used interchangeably is “Profession” and “Industry” when referring to O&P care.  Before we can talk about whether data is a help or a hindrance, we have to understand what we mean by the “patient care.”

Words matter.  If we truly believe that the role of an O&P practitioner is primarily to fill prescriptions, I think we are correct in referring to our care as an industry or a trade.  But, we don’t. We care about our patients, their lives, and their families. We provide care with more than just our intellect and our skills. This is what allows us to cross the chasm between an industry and a profession.  We are a critical part of the healthcare team committed to treating the person, not the ailment. Take a look at ABCOP’s Code of Professional Responsibility C2.1.

“It is the responsibility of the ABC Credential Holder to work in conjunction with physicians and other licensed healthcare prescribers to determine the medical appropriateness of the orthosis, prosthesis or pedorthic device…”  That, my friends, makes us an integral part of the healthcare continuum. In 2015, the American Medical Association’s Journal of Ethics, published an article that stated “the key to improving outcomes for those who have lost limbs is to ensure that they receive appropriate and comprehensive interdisciplinary care to address both their physical and psychosocial needs. Fundamental to the rehabilitative care and recovery of many people who have lost limbs is their fitting for and training on the use of prostheses.”

“Patient care” is more than just providing an orthosis or a prosthesis.  It is the act of providing the best available solution for a patient that addresses their physical, mental, and emotional well-being.  In order to be what the ABC Code of Professional Responsibility calls for; we must engage in collaborative dialogue with the other members of the patient’s rehabilitation team and we must be able to contribute meaningfully to the overall patient care plan.  However, to be taken seriously, we must be able to back our opinions with data.

Let me answer the question I asked above with another question: Can you provide effective patient care without data? That is a rhetorical question and you should have screamed out in your head “of course not!”

But what data do we need to focus on?

As the clinician, there is so much we can share.  ROM, height, weight, circumference, outcomes scores, etc.  These are all important, but they alone are not enough.  We can’t assume that others, even other medical professionals, know what we know.  When you are collecting data for a patient, think about the story you want to tell with that data.

What is the care plan for the patient and what information will demonstrate how effective our intervention was?  What information might indicate that physical or other changes have occurred that make a revision to the care plan necessary to get the patient back on course?  Remember that your care plan is, or should be, part of the overall care plan for that patient.  Sometimes, it is appropriate to modify or revisit areas beyond our scope. Would the patient benefit from another professional’s intervention, such as physical therapy, diabetic counseling, a revision surgery, or advanced wound care?

Even if you modify your own care plan, is there a benefit in notifying the other professionals caring for that patient of your changes and why you thought they were necessary?  When you reach out to the other team members for help, being about to support your request with data, rather than an opinion alone, will help you integrate yourself more effectively into the care team and will help solidify your membership in the profession of patient care.

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