Weekend seminar in beautiful Asheville, NC
with Dr. Frank King Jr., ND, DC
May 21 - 22, 2011
www.safecarerx.com or 828.398.2071 for details
*Qualifies for 12 hours of CEUs* for chiropractors in GA, NC, SC, TN, and UT.
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most cases, patients will complete the forms prior to the
conclusion of their first visit. They may take home the
remaining forms if they do not complete them all (expect
about a 50% return rate, in which case, re-administer
uncompleted forms at the 2nd visit). When you enter
to examine the patient, THANK them for taking care
when completing the forms, and explain the importance of tracking care accurately—to promote patient
compliance.
C. Possible OA scenarios:
1. A plateau (Max. Therapeutic Benefit—MTB) short of pre-injury
resolution has been reached:
Partial Disability (PPD) ONLY if applicable.
d. Explain to patient, care may be required when
home-based therapies are non-satisfying.
2. A plateau has not been established (frequent remission/exacerba-tions).
a. Consider additional forms of care including:
1. Home-based exercise program.
2. If already implemented, in-office rehab with pre- and post- Quantitative Functional Capacity Evaluation (QFCE) to objectively support
the “medical necessity.”
3. Co-treatment with allied health care providers, especially if no
in-office rehab available.
4. Patient’s Outcomes Assessment Tools (OATs) scores are worsening.
a. Review patient’s history for exacerbations.
b. Discuss with patient outside/homework physical
demands & tolerance.
c. Consider ergonomic factors/work station evaluation.
d. Consider poor patient compliance.
e. Consider inappropriate care (iatrogenic cause).
4)Prove the long-term benefits of chiropractic care by sending the
patient the same OATs forms at a 6- and/or 12-month point post-discharge. This will also serve as an excellent patient recall/reminder,
if their condition is unstable/failing/recurrent (see Table 2).
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II. Outcomes Assessment (SUBJECTIVE)
A. Overview: Which tool(S) to utilize?
i. An immediate practical challenge for the clinician is to determine
which instrument or instruments would be most optimal in assessing
specific outcomes.
ii. Table 1 offers an abridged summary of the goals of the outcomes
assessment tool and several instruments from wich one may choose.
As you can see, up to 4 tools in total are recommended to be used
initially. However, this recommendation has been modified over the
years and currently, I suggest that only the pain and condition specific/
hybrid tools be considered. Omitting the General Health tool is wise as
it is not sensitive / responsive to short-term changes in patient status.
Also, I recommend a pain diagram be photocopied onto the opposite
side of the Bournemouth Questionnaires. I usually ask the 4 QVAS
(Quadruple Visual Analogue Scale) questions verbally, as I’m taking the patient’s history initially and on daily office visits, so that To learn more, circle #81 on The Action Card
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