Has the quality of physiotherapy care in patients with whiplash-associated disorders (WAD) improved over time? a retrospective study using routinely collected data and quality indicators: A retrospective study using routinely collected data and quality indicators

Rob A.B. Oostendorp, Hans Elvers, Emiel van Trijffel, Geert M. Rutten, Gwendolyne G.M. Scholten-Peeters, Marcel Heijmans, Erik Hendriks, Emilia Mikolajewska, Margot De Kooning, Marjan Laekeman, Jo Nijs, Nathalie Roussel, Han Samwel

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Purpose: To develop valid quality indicators (QIs) for physiotherapy care based on best available evidence, and to use these QIs to explore trends in the quality of physiotherapy care of patients with Whiplash-associated disorders (WAD) using guideline-based routinely collected data (RCD) gathered between 1996 and 2011.

Materials and methods: The study consisted of two phases: 1) development of QIs and 2) analysis of patient records. A set of QIs was developed based on recommendations in the scientific literature and the Dutch Clinical Practice Guideline (CPG) "Physiotherapy Management and WAD". QIs were expressed as percentages, allowing target performance levels to be defined (≥80% or ≤30% depending on whether desired performance required a high or low score on a QI). We then analyzed WAD patient data (N = 810) collected over a period of 16 years in two physiotherapy practices, separating patients into two groups defined as before (Group A 1996-2002; n = 353) and after (Group B 2003-2011; n = 457) implementation and transition to the Dutch CPG "Physiotherapy Management and WAD".

Results: Using an iterative process and input from both experts and users, 28 QIs were developed and subsequently classified per step of the clinical reasoning process for physiotherapy care. Based on 16 years of RCD, we found that the clinical reasoning process differed significantly (P ≤ 0.05) between the groups, in favor of Group B. Twelve of the 25 indicators (48.0%) in Group A and 19 of 26 indicators (73.1%) in Group B met predetermined performance targets. The number of target indicators also differed significantly between groups, favoring Group B (P ≤ 0.05).

Conclusion: A preliminary set of novel QIs was developed. Using RCD and these QIs, we conclude that physiotherapy care in our study setting improved over the period 1996-2011. Furthermore, the QIs met the performance targets set for the clinical reasoning process after the transition to the Dutch CPG "Physiotherapy Management and WAD".

Original languageEnglish
Pages (from-to)2291-2308
Number of pages18
JournalPatient Preference and Adherence
Volume12
DOIs
Publication statusPublished - 8 Nov 2018

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Quality of Health Care
Retrospective Studies
Practice Guidelines
Literature
Group
Guidelines
Data Accuracy
time
performance
management
technical literature

Keywords

  • Clinical guidelines
  • Clinical reasoning process
  • Quality indicators
  • Quality of physiotherapy care
  • Routinely collected data
  • Whiplash-associated disorders

Cite this

Oostendorp, Rob A.B. ; Elvers, Hans ; Trijffel, Emiel van ; Rutten, Geert M. ; Scholten-Peeters, Gwendolyne G.M. ; Heijmans, Marcel ; Hendriks, Erik ; Mikolajewska, Emilia ; De Kooning, Margot ; Laekeman, Marjan ; Nijs, Jo ; Roussel, Nathalie ; Samwel, Han. / Has the quality of physiotherapy care in patients with whiplash-associated disorders (WAD) improved over time? a retrospective study using routinely collected data and quality indicators : A retrospective study using routinely collected data and quality indicators. In: Patient Preference and Adherence. 2018 ; Vol. 12. pp. 2291-2308.
@article{49b920d188114ba4abdb1a761f2419bc,
title = "Has the quality of physiotherapy care in patients with whiplash-associated disorders (WAD) improved over time? a retrospective study using routinely collected data and quality indicators: A retrospective study using routinely collected data and quality indicators",
abstract = "Purpose: To develop valid quality indicators (QIs) for physiotherapy care based on best available evidence, and to use these QIs to explore trends in the quality of physiotherapy care of patients with Whiplash-associated disorders (WAD) using guideline-based routinely collected data (RCD) gathered between 1996 and 2011.Materials and methods: The study consisted of two phases: 1) development of QIs and 2) analysis of patient records. A set of QIs was developed based on recommendations in the scientific literature and the Dutch Clinical Practice Guideline (CPG) {"}Physiotherapy Management and WAD{"}. QIs were expressed as percentages, allowing target performance levels to be defined (≥80{\%} or ≤30{\%} depending on whether desired performance required a high or low score on a QI). We then analyzed WAD patient data (N = 810) collected over a period of 16 years in two physiotherapy practices, separating patients into two groups defined as before (Group A 1996-2002; n = 353) and after (Group B 2003-2011; n = 457) implementation and transition to the Dutch CPG {"}Physiotherapy Management and WAD{"}.Results: Using an iterative process and input from both experts and users, 28 QIs were developed and subsequently classified per step of the clinical reasoning process for physiotherapy care. Based on 16 years of RCD, we found that the clinical reasoning process differed significantly (P ≤ 0.05) between the groups, in favor of Group B. Twelve of the 25 indicators (48.0{\%}) in Group A and 19 of 26 indicators (73.1{\%}) in Group B met predetermined performance targets. The number of target indicators also differed significantly between groups, favoring Group B (P ≤ 0.05).Conclusion: A preliminary set of novel QIs was developed. Using RCD and these QIs, we conclude that physiotherapy care in our study setting improved over the period 1996-2011. Furthermore, the QIs met the performance targets set for the clinical reasoning process after the transition to the Dutch CPG {"}Physiotherapy Management and WAD{"}.",
keywords = "Clinical guidelines, Clinical reasoning process, Quality indicators, Quality of physiotherapy care, Routinely collected data, Whiplash-associated disorders",
author = "Oostendorp, {Rob A.B.} and Hans Elvers and Trijffel, {Emiel van} and Rutten, {Geert M.} and Scholten-Peeters, {Gwendolyne G.M.} and Marcel Heijmans and Erik Hendriks and Emilia Mikolajewska and {De Kooning}, Margot and Marjan Laekeman and Jo Nijs and Nathalie Roussel and Han Samwel",
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language = "English",
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publisher = "Dove Medical Press Ltd.",

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Has the quality of physiotherapy care in patients with whiplash-associated disorders (WAD) improved over time? a retrospective study using routinely collected data and quality indicators : A retrospective study using routinely collected data and quality indicators. / Oostendorp, Rob A.B.; Elvers, Hans; Trijffel, Emiel van; Rutten, Geert M.; Scholten-Peeters, Gwendolyne G.M.; Heijmans, Marcel; Hendriks, Erik; Mikolajewska, Emilia; De Kooning, Margot; Laekeman, Marjan; Nijs, Jo; Roussel, Nathalie; Samwel, Han.

In: Patient Preference and Adherence, Vol. 12, 08.11.2018, p. 2291-2308.

Research output: Contribution to JournalArticleAcademicpeer-review

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T2 - A retrospective study using routinely collected data and quality indicators

AU - Oostendorp, Rob A.B.

AU - Elvers, Hans

AU - Trijffel, Emiel van

AU - Rutten, Geert M.

AU - Scholten-Peeters, Gwendolyne G.M.

AU - Heijmans, Marcel

AU - Hendriks, Erik

AU - Mikolajewska, Emilia

AU - De Kooning, Margot

AU - Laekeman, Marjan

AU - Nijs, Jo

AU - Roussel, Nathalie

AU - Samwel, Han

PY - 2018/11/8

Y1 - 2018/11/8

N2 - Purpose: To develop valid quality indicators (QIs) for physiotherapy care based on best available evidence, and to use these QIs to explore trends in the quality of physiotherapy care of patients with Whiplash-associated disorders (WAD) using guideline-based routinely collected data (RCD) gathered between 1996 and 2011.Materials and methods: The study consisted of two phases: 1) development of QIs and 2) analysis of patient records. A set of QIs was developed based on recommendations in the scientific literature and the Dutch Clinical Practice Guideline (CPG) "Physiotherapy Management and WAD". QIs were expressed as percentages, allowing target performance levels to be defined (≥80% or ≤30% depending on whether desired performance required a high or low score on a QI). We then analyzed WAD patient data (N = 810) collected over a period of 16 years in two physiotherapy practices, separating patients into two groups defined as before (Group A 1996-2002; n = 353) and after (Group B 2003-2011; n = 457) implementation and transition to the Dutch CPG "Physiotherapy Management and WAD".Results: Using an iterative process and input from both experts and users, 28 QIs were developed and subsequently classified per step of the clinical reasoning process for physiotherapy care. Based on 16 years of RCD, we found that the clinical reasoning process differed significantly (P ≤ 0.05) between the groups, in favor of Group B. Twelve of the 25 indicators (48.0%) in Group A and 19 of 26 indicators (73.1%) in Group B met predetermined performance targets. The number of target indicators also differed significantly between groups, favoring Group B (P ≤ 0.05).Conclusion: A preliminary set of novel QIs was developed. Using RCD and these QIs, we conclude that physiotherapy care in our study setting improved over the period 1996-2011. Furthermore, the QIs met the performance targets set for the clinical reasoning process after the transition to the Dutch CPG "Physiotherapy Management and WAD".

AB - Purpose: To develop valid quality indicators (QIs) for physiotherapy care based on best available evidence, and to use these QIs to explore trends in the quality of physiotherapy care of patients with Whiplash-associated disorders (WAD) using guideline-based routinely collected data (RCD) gathered between 1996 and 2011.Materials and methods: The study consisted of two phases: 1) development of QIs and 2) analysis of patient records. A set of QIs was developed based on recommendations in the scientific literature and the Dutch Clinical Practice Guideline (CPG) "Physiotherapy Management and WAD". QIs were expressed as percentages, allowing target performance levels to be defined (≥80% or ≤30% depending on whether desired performance required a high or low score on a QI). We then analyzed WAD patient data (N = 810) collected over a period of 16 years in two physiotherapy practices, separating patients into two groups defined as before (Group A 1996-2002; n = 353) and after (Group B 2003-2011; n = 457) implementation and transition to the Dutch CPG "Physiotherapy Management and WAD".Results: Using an iterative process and input from both experts and users, 28 QIs were developed and subsequently classified per step of the clinical reasoning process for physiotherapy care. Based on 16 years of RCD, we found that the clinical reasoning process differed significantly (P ≤ 0.05) between the groups, in favor of Group B. Twelve of the 25 indicators (48.0%) in Group A and 19 of 26 indicators (73.1%) in Group B met predetermined performance targets. The number of target indicators also differed significantly between groups, favoring Group B (P ≤ 0.05).Conclusion: A preliminary set of novel QIs was developed. Using RCD and these QIs, we conclude that physiotherapy care in our study setting improved over the period 1996-2011. Furthermore, the QIs met the performance targets set for the clinical reasoning process after the transition to the Dutch CPG "Physiotherapy Management and WAD".

KW - Clinical guidelines

KW - Clinical reasoning process

KW - Quality indicators

KW - Quality of physiotherapy care

KW - Routinely collected data

KW - Whiplash-associated disorders

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