The Use of Quality Improvement in the Physical Therapy Literature: A Scoping Review.

INTRODUCTION: Quality improvement (QI) is a useful methodology for improving healthcare, often through iterative changes. There is no prior review on the application of QI in physical therapy (PT). PURPOSE AND RELEVANCE: To characterize and evaluate the quality of the QI literature in PT. METHODS: We searched four electronic databases from inception through September 1, 2022. Included publications focused on QI and included the practice of PT. Quality was assessed using the 16-point QI Minimum Quality Criteria Set (QI-MQCS) appraisal tool. RESULTS: Seventy studies were included in the review, 60 of which were published since 2014 with most ( n = 47) from the United States. Acute care ( n = 41) was the most prevalent practice setting. Twenty-two studies (31%) did not use QI models or approaches and only nine studies referenced Revised Standards for QI Reporting Excellence guidelines. The median QI-MQCS score was 12 (range 7-15). CONCLUSIONS/IMPLICATIONS: Quality improvement publications in the PT literature are increasing, yet there is a paucity of QI studies pertaining to most practice settings and a lack of rigor in project design and reporting. Many studies were of low-to-moderate quality and did not meet minimum reporting standards. We recommend use of models, frameworks, and reporting guidelines to improve methodologic rigor and reporting.

Rapid Facial Cryotherapy for Combat Sports: A Comparison of Materials and Methods for Cooling Facial Tissues in 60 Seconds or Less.

CONTEXT: Athletes in combat sports who have sustained facial hematomas during competition have traditionally been treated with an enswell. These treatments take place between rounds of the competition and generally last less than 60 seconds. The efficacy of this modality has not been studied. Other modalities may provide a more effective cryotherapy treatment in this timeframe. OBJECTIVE: To compare the efficacy of different forms of rapid cryotherapy to cause surface temperature changes of the face within 60 seconds of application. DESIGN: Crossover study. SETTING: Laboratory. PARTICIPANTS: Eleven healthy men (age 21.73 [1.42] y, mass 82.1 [5.6] kg, height 177.2 [7.0] cm). INTERVENTIONS: A 60-second treatment using chilled surgical steel enswell, copper, commercial cold pack, aluminum, brass, ice cube, ice pack, and saltwater pack. MAIN OUTCOME MEASURES: Preintervention and postintervention surface facial temperatures. RESULTS: The ice bag, cold pack, ice cube, saltwater pack, and stainless-steel enswell caused statistically different temperatures preintervention to postintervention. The ice bag and saltwater pack cause statistically greater cooling than the other materials tested. CONCLUSIONS: This study does not support the clinical use of an enswell to provide short-duration cryotherapy treatments to facial tissue, as ice packs are more effective.