Page 24 - Mobility Management, March 2017

ATP
efficacy of complex rehab
Q: Why
Gre
p
g Packer:
to be cut
roviding the appropri
atients tantly,
ance too
star
(CM
Q: He
P
it
ting to
S) to
mentality that C
g p
et
ric
alth
ac
Se
Eviden
president
important
Fundin
by Medicare and
tive, integra healthier and
l for AT
selection and fitting sions decrease.
p C
T
he
roperly RT indu
re
is no
would prove the
canes or
se
fitting a p stry, it is e
cu
t funding.
ries
gf
Ps. With the
e some
evidence
MS has;
care tod
it important for CRT t
acker: It would be nice to b
crutches, ho
or
to h
co
for years, telling our stories of how CRT is important. While ongress do about they continua
of C
show that CRT wor
a
It is
Mobility
o
utcomes r Our ai
spend
p
ve
ry
As
m
hard
sessment
is to
to
wheelchair use. It also is very diffi pressure sore why they received
ing on patients over t
ks
unders
(FMA) will
stori
and is appro
tand
eceived.
provide evidence that CRT
ate c
c
how
pr
ushion, w
e
S. Rehab, on
technology (CRT).
ave
ted into society, work The FM
out of hospitals.
data
We want to reduce the d
showing them
this done. Evidence-based da is where we portional the healthcare arena
e pro
ay works on an evide
point. But with
w do
you tell som
ta
evidence t
mplex rehab technolo
Medicaid. We have go
priate for certa
ov
heir lifetime
to
whe
do a
&
why it’s critical
cult to determine
it. We believe that t
ide the
heelchair
we have already
correlation that when an ATP is involved
of
th
e mobility intervention,
currently of how important
atient to a mobility int asy for the Centers for
data
data
.
does d
s. We hop
is
elchair users
eone that
in
to
Ou
and accessory
to prove the
hat CRT works?
ne
gy
to W
(CRT
ing, and most i or- A is a qua - r-
collected
hospital rea
an ATP
ervention. Without data in the Medicare & Medicaid Services
rive-to-the-botto
the only way that
can affect
) con
members ask for the data to
disease
double-blind study
quantif
nce-based system. Is
o keep pace with this metri
e able to do double blind studies, and
th
and/or
ey
states.
ter a patient he Functional
y the
ecrease overall
e to show that
tc
tinues
ashington, D.C.,
in
, we are
is when
c?
scoo
are not able
in
dmis
m
has
keeps
we c
policy and
ters,
th
to
e
an
24 march 2017 | mobilitymanagement mobilitymgmt.com
o
Q:
fitted
be
tracked
mes
CRT. — Delia “Dee Dee” Freney, OTR/L, ATP, occupational thera- pist, Continuing Care Service Center — DME, Kaiser Permanente
Problem-Solving + Creativity
I believe it is important to use outcome measures to track whether our recommendations have actually met a client’s goals. If we have no measure of the effectiveness of our interventions, we are less likely to modify — and hopefully improve — those strategies.
Yet on the other hand, I routinely encounter professionals
who request evidence-based articles or assessments to help them determine the best interventions. I work with complex clients who
are each unique individuals. It is unlikely that a journal article is going to specifically inform me as to where to place a switch for access to a communication device for a child with cerebral palsy. I still must rely on basic assessment, problem-solving, and a degree of creativity. — Michelle L. Lange, OTR/L, ABDA, ATP/ SMS, Access to Independence, Inc.
The Best, Not the Cheapest
When I look at our current climate, I think it is becoming neces- sary to have evidence-based outcomes in mind when choosing equipment. The IMPACT ACT of 2014 has brought increased
Funding & the Functional Mobility Q&A with Greg Packer, U.S. Rehab
Gre
g Packer,
of
U.
get a chair
stu
dies,
How c
Packer:
de-identifi
data to be
equi
and [th
you can see
ould e
True
on the FM
With that sai
use the same outcome
outcomes serving
Q:
W
Packer:
at
program. Sample siz
to show
client
tool, best.
able
statistical
s with s
im
to
en ask]
at
vidence
evidence-base
ed relationship that
vider w
CMS
hat are the challen
One
of
our bigge
su
pport the
es
if they can just
rue evidence-bas
pactful when enough
Like how many falls patient
pment utilizing an ATP. H
transfers? These are a few of the items w
Q:
Do you think the p
outcome measures will continue?
Packer:
is s
hif
done through outcom
A.
If we
imp
can show
A
act fund
ush for evidence-b
ho has ATPs o staff need for CRT.
will see all d
y the
d, it is incredibly important
s measuremen
ges to
are definitely a
significance
ilar circumstances.
ve
ata coll
research behin
in
certain
For example, we may want to look at ALS patients who are prescribe a Group 3 power wheelchair and what it do to their FMA score. A larg
sample size is necessary to find hundreds of patients that match these
specific characteristics and t
o show
ssessment:
Outcomes will continue to be important. The medical industry ting to a performance-based pay system. Proof of better care can
es
data. Hospit
that
walk
ed
d research with the true arm’s
VGM
di
in
is collecte re ha
sa
ow does a seat
e are
providing
th
anyway?
fference.
g so
has with University
da
ta
se
urce d
makes an
at
t system. Without a
d this q
areas, we
es
statistical significance.
quality
the entire
ected as invalid and self-
proving
st challenges currently is
that CRT wo
getti
With
of
d to show correlative ving with prop
eing.
al readmissions is
elevator help with
ased practices
impact
uality-a
concern. Since our industry is
an
state alysis is
in
l
placebo
ecisions?
length,
Pittsbu
one ite
equi
rk
ng enough
erly
on
dustry
standard
s?
ssurance
s, it is necessary done. To be
need hun
dreds of
rgh
and
m
pment
able
so
d
e
is it
care es,
lly
should be im information.
from a quality pro n readmissions, we will solidif
unique and our clients ha a variety of disease to collect a large volume of data before an
af
mp lity assu
-
ly in