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The quality of physiotherapy care: the development and application of quality indicators using scientific evidence and routinely collected data embedded in the process of clinical reasoning

Bulletin of Faculty of Physical Therapy volume 24, pages 113–120 (2019)Cite this article

Abstract

Quality improvement has become a central tenet of physiotherapy care. Quality indicators (QIs) as measurable elements of care have been used over the past 25 years to analyze and evaluate the quality of physiotherapy care. The aim of this article is to describe the state of the art regarding the development and application of QIs in physiotherapy primary care when embedded in a clinical reasoning process. In contrast to international clinical practice guidelines, Dutch physiotherapy clinical practice guidelines are generally based on the clinical reasoning process in combination with best available evidence. Information required to develop QIs is preferably derived by combining available systematic review-based scientific evidence, guideline-based recommendations, and routinely collected data with clinical evidence, professional expertise and standards, and patient perspectives. A set of QIs (n=28) in patients with whiplash-associated disorders was developed and embedded per step of the clinical reasoning process in physiotherapy care: (a) administration (n=2); (b) history taking (n=7); (c) objectives of examination (n=1); (d) clinical examination (n=4); (e) analysis and conclusion (n=2); (f) treatment plan (n=3); (g) treatment (n=2); (h) evaluation (n=5); and (i) discharge (n=2). The use of QIs represents a useful tool for measuring the (improvement of) quality of physiotherapy primary care, as many evidentiary gaps still exist in terms of diagnostics, prognostics, and treatment, and concerning patient-related outcome measurements in different patient groups such as patients with musculoskeletal pain. The recommended set of QIs embedded in the clinical reasoning process for patients with whiplash-associated disorders can be used as a starting point for the development of a general set of QIs that measure the (improvement of) quality of primary care physiotherapy.

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Author information

Authors and Affiliations

  1. Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, Oude Kleefsebaan 325, 6572, AT Berg en Dal, The Netherlands

    Rob A.B. Oostendorp Prof. Rob A.B. Oostendorp, PhD, PT, MPT

  2. Department of Manual Therapy, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium

    Rob A.B. Oostendorp Prof. Rob A.B. Oostendorp, PhD, PT, MPT & Emiel van Trijffel

  3. Department of Physiotherapy, International Research Group - Pain in Motion, Vrije Universiteit Brussel, Brussels, Belgium

    Rob A.B. Oostendorp Prof. Rob A.B. Oostendorp, PhD, PT, MPT

  4. Practice Physiotherapy and Manual Therapy, Heeswijk-Dinther, The Netherlands

    Rob A.B. Oostendorp Prof. Rob A.B. Oostendorp, PhD, PT, MPT

  5. Department of Public Health and Research, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

    J.W. Hans Elvers

  6. Department of Education, SOMT University of Physiotherapy, Amersfoort, The Netherlands

    Emiel van Trijffel

  7. Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium

    Emiel van Trijffel

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  1. Rob A.B. Oostendorp Prof. Rob A.B. Oostendorp, PhD, PT, MPT
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  2. J.W. Hans Elvers
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  3. Emiel van Trijffel
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Corresponding author

Correspondence to Rob A.B. Oostendorp Prof. Rob A.B. Oostendorp, PhD, PT, MPT.

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Oostendorp, R., Hans Elvers, J. & van Trijffel, E. The quality of physiotherapy care: the development and application of quality indicators using scientific evidence and routinely collected data embedded in the process of clinical reasoning. Bull Fac Phys Ther 24, 113–120 (2019). https://doi.org/10.4103/bfpt.bfpt_4_19

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  • DOI: https://doi.org/10.4103/bfpt.bfpt_4_19

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