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Measuring Quality in Physical Therapy

How can you measure the quality of care? In the world of Physical Therapy, it can be difficult as many symptoms require the care of a therapist, but still take time to heal. If a symptom takes longer to heal, does that mean the patient is receiving lower quality care?

We all know that measuring quality of care is a lot more complex than just measuring the change in two points in time. A Physical Therapist (PT) provides services to the patient who drives the process; the patient must visit a PT for a specific purpose. There are four specific reasons patients visit PTs: 1.) proactive: to stay healthy, 2.) reactive: to treat an injury/disease/illness, 3.)coping function: to learn to live with a disability or illness, or 4.) final measures: to cope with end of life.

In general, people visit a PT mainly as a reactive function of their daily life. Injuries, diseases, and illnesses take a toll on the body and a PT can aid in the recovery or help a person cope by taking reactive measures to strengthen and soothe pain points in the body. This reactive healing process depends on the quality of care received by the patient as well as the patient’s individual body reactions. Since each treatment plan is customized for a specific person and their specific problem, quality measurements are difficult as this process cannot sustain a standardization process.

Another option for quality measurement is the decrease in pain in a patient. Quite a few people seeking the expertise of a PT do so because they are tired of feeling pain. If we choose to use reduction of pain as a quality indicator, it isn’t as simple as we’d intuitively think. The location of pain and the onset of pain are factors to be considered when interpreting change in pain. The duration of the episode of care might even need to be considered. So, again, reduction in pain is not an easy measurement tool either.

The long and short answer is that there is not a concrete way to measure the quality of care received by a patient. This makes it difficult to justify services to other healthcare professionals and insurance companies. If a patient continues to have a nagging injury, or continues to report pain, how long will an outside company pay for that patient to receive care before they decide that the patient is not receiving quality care? This is an issue that PTs struggle with daily and there is not a solid answer, but the job of a PT remains to help patients with the top 4 reasons they seek services.

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