Project to make program evaluation meaningful
Staff take ownership of their work
If program evaluation isn’t meaningful to the therapists who are treating patients, then it’s a waste of time, Brett Oakley, MS, asserts. That’s why he challenged each of Florida Hospital’s eight outpatient rehabilitation centers to come up with their own program evaluation data to track.
"Program evaluation is often viewed as a ecessary evil; something we have to do for accreditation. Everybody focuses for six months working on program evaluation, then forgets about it as soon as the surveyors leave," he says.
Making evaluation a habit
Oakley’s mission as coordinator of program outcomes for the Orlando, FL, hospital is to make program evaluation a routine part of everybody’s job to encourage all staff to think about how everything they do is going to affect quality.
Oakley asked staff at each of the eight outpatient clinics to pick an area that makes their center unique and to come up with a program evaluation project.
"It gives the staff good reinforcement and gives them ownership in what they think is good about their center," he says.
Eventually, Oakley may incorporate some of the projects in the hospital’s program evaluation system for everyone to use. But for the next year or two, the centers are all "doing their own thing."
Focusing on workers’ comp
Following are some of the projects that staff at Florida Hospital’s rehab centers picked:
• Writing functional goals for return-to-work patients.
Some therapists have a hard time making their goals meaningful for workers’ compensation patients. Their improvement project is to get all staff therapists to write goals that are not just clinically measurable but that relate to a patient’s return to work.
For instance, a goal that says "increase range of motion from 120 degrees to 125 degrees has little meaning in terms of whether a patient will be able to return to work.
"We want the therapists to ask themselves if that 5 degrees will get patients back to work or help them be more independent. If the answer is no, then they should question why they are doing it," Oakley says. This ensures that therapy goals have real-life applications.
Exercise and injuries
• All patients will be taught a home exercise program and be able to do it independently by the end of the second visit.
The aim of the project is to emphasize that, to get better, patients have to do more than just show up for therapy.
Staff plan to compare patients who met exercise goals with those who didn’t to see if independence in home exercise can reduce the number of visits.
At the 90-day follow-up, staff will determine whether the patients who learned the home exercise program early are still doing it and whether they have fewer additional injuries than patients who are not exercising.
• A comparison of re-injury among patients who join a wellness program vs. those who do not.
This study of orthopedic patients will track reinjuries of patients to see if long-term participation in a wellness program can prevent future problems.
• The staff will make three visits per quarter to employers to promote the industrial medicine work capacity center.
This small center’s staff of two therapists and a team leader plan to make their visits a combination of inservice training on wellness and body mechanics and to make employers aware of the services that the center can offer to employees.
• All back patients will complete a videotaped educational series by the end of the sixth visit.
The center will track the outcomes and future injuries of the patients who complete the educational series.
[Editor’s note: For more details on Florida Hospital Rehabilitation Center’s program evaluation projects, contact Brett Oakley at (407) 895-7948.]
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