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.

Common reasons for non-participation during the outcome measurement process: wheeled mobility service delivery quality improvement reporting.

OBJECTIVE: The purpose of this paper is to describe non-participation during the outcome measurement step of the wheeled mobility service delivery process (WMSDP) based on the Functional Mobility Assessment (FMA)-Uniform Dataset (UDS) Registry. INTRODUCTION: The WMSDP is a standard framework for the provision of wheeled mobility devices, and several factors influence the client's experience throughout the process. Patient-reported outcomes are one way to measure the client's experience as part of a quality improvement program. METHODS: A retrospective descriptive study was conducted on the FMA-UDS Registry to measure the response rate during the outcome measurement step of the WMSDP and describe the reasons an individual did not complete the FMA-UDS. The FMA-UDS was examined at two time points: pre-delivery and post-delivery of the wheeled mobility device. RESULTS: As of September 2, 2021, 10,253 cases have been entered into the FMA-UDS Registry. 2,247 cases were no longer participating pre-delivery, and an additional 3,905 cases were no longer participating post-delivery. The most common reasons for non-participation in the FMA-UDS pre-delivery and post-delivery included: equipment not delivered; provider no longer participating in the FMA-UDS; funding issues; no new equipment; client opted out; loss in contact; deceased; returned equipment; and other. DISCUSSION: The type and frequency of non-participation in the outcome measurement step of the WMSDP is critical to understanding why individuals participate in outcome measures and provides insight into the barriers and facilitators for the implementation of quality improvement programs.

The outcome measurement system provides a structured mechanism for consistent communication between the client and the professionals providing the service, thereby identifying issues earlier in the process and mitigating frustration throughout the wheeled mobility service delivery process.The role of a credentialed professional, specifically an Assistive Technology Professional, in the wheeled mobility service delivery process could emphasize the importance of the follow-up and outcome measurement steps, which may increase the consumers' participation rate and demonstrate the effectiveness of devices and services.Clients who no longer participate in the outcome measurement process do not have the sustained support of the interprofessional team, and possess an increased chance that they will not get their mobility needs met through the health care system.

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.