Category: Measurement; Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development)
Objective : To query the Epic documentation system for large data sets with the goal of analyzing key metrics used in defining value-based care for occupational and physical therapy departments.
Design : Using a case study design for quality improvement, we analyzed data from Septmeber 1st, 2018 to January 31st, 2019 in order to report descriptive and frequentist outcomes related to metrics identified to be crucial in value-based and cost-effective delivery of rehabilitation care within the acute care environment.
Setting : This study occurred in an 894 bed academic acute care hospital within a major midwestern metropolitan city in the United States.
Participants (or Animals, Specimens, Cadavers) : 11456 distinct admissions to all acute care hospital units between the dates September 1st, 2018 and January 31st, 2019 were included in this sample. All included participants received an occupational therapy consult, a physical therapy consult, or both consults at any point during their admission. No exclusions were made.
Interventions : Epic Flowsheets were created within our occupational therapy and physical therapy documentation to capture discrete variables for every patient encounter. Using SQL, Epic documentation was queried in order to extract 30 discrete variables for every patient with a therapy consult.
Main Outcome Measure(s) : Primary outcome measures are response to referral, adherence to treatment frequency, relative value units per hour worked, AMPAC 6-clicks scores, post-acute care utilization.
Results : 71.66% of OT and PT consults were responded to within 24 hours. 75.70% of treatment plans were met throughout a patient's admission. 1.5 RVUs billed per hour, 68% discharged home, 15% SNF, 11% IRF, 6% readmitted. AMPAC 6-clicks change scores ranged between 2-3 points.
Conclusions : Querying Epic flowsheets enables rehabilitation managers to monitor metrics integral to the delivery of value-based care.
Kevin Pritchard– Occupational Therapist, UTMB, Galveston, Texas
Christine Stankiewicz– Manager of Rehabilitation Services, Northwestern Memorial Hospital, Chicago, Illinois
Abram Beyer– Analytics Consultant, Northwestern Memorial Hospital, Chicago, Illinois
Lydia VanZalen– Performance Improvement Leader, Northwestern Medicine, Chicago, Illinois
Ankit Shah– EPIC certified Instructional Designer/ Physical Therapist, Northwestern Medicine, Skokie, Illinois
Andrea Williams– Education Coordinator - Rehabilitation Services Department, Northwestern Medicine, Chicago, Illinois
Matthew Bednarczyk– Physical Therapy Resource Coordinator, Northwestern Memorial Hospital, Chicago, Illinois