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Invisible Ways to Improve Patient Outcomes

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Achieving great results for patients is the top priority for physical therapists. Clinicians want to help clients improve their quality of life and reach as many treatment goals as possible. And this effort extends well beyond exercises or stretches.

Various outcome measures objectively evaluate patient success from plans of care, and run the gamut from a 6-minute walk test to the Oswestry Disability Index and everything in between. But there are some aspects of treatment that are more interpersonal, and no less important. Beyond the rigorous specialty certifications and medical know-how, the following are some significant ways to contribute toward overall care, and deliver positive results and experiences during treatment.

Positive communication and empathy

In a world where patients often spend an average of 18 minutes with their primary healthcare providers, physical therapists have an advantage. Therapists typically have more time to spend one-on-one with patients through the initial evaluation and follow-up visits. This allows the therapist to have a positive impact using their words and demeanor.

So often, patients are feeling frustrated and defeated about their current condition. All they really need to get moving in the right direction is someone who will listen to them and make them feel heard. In a recent study, the effects of provider communication and empathy were evaluated. Patients who experienced positive communication with empathy for their condition/situation had improved healthcare outcomes.

Listening to patients with an open ear and heart allows you to learn more about what is happening with each patient to guide their treatment. Perhaps their current situation does not allow for a significant time to complete a home exercise program. With that knowledge, you can provide a short but effective routine that is manageable for that patient without seeming overwhelming. On the other hand, maybe you have a patient who has been battling chronic pain and feels their providers may be dismissing it as “all in their head.” Providing pain science education for these individuals may be a step in the right direction to improving outcomes.

Manage patient expectations

Patients come to physical therapy with certain expectations that are formed by their life experiences. Oftentimes, it may be based on a friend or family member who had the “same thing.” In a systematic review published in the Physical Therapy & Rehabilitation Journal in February 2022, patients who typically had high or neutral expectations regarding physical therapy had favorable outcomes. These patients were also likely to have high self-efficacy and interest in fully participating in their treatment. Interestingly, patients with high expectations and higher levels of disability were more likely to report unfavorable outcomes, suggesting their expectations were not fully addressed.

The clinical implications to evaluate, set, and manage patient expectations can be crucial to their successful outcomes. There are no universal guidelines to assess patient expectations regarding their physical therapy journey. However, the authors in the study above recommend asking patients, “Please indicate your agreement (agree, unknown, disagree) with the following statement: I believe I will recover from my current injury or health condition” to determine initial patient expectations. This simple question allows the physical therapist to help patients set and manage their expectations.

Patients could be provided with more robust education regarding their specific diagnosis and plan of care to help ease their minds as well as set them up for more successful outcomes. In addition, discussing tissue healing timeframes and loading is important for patients to understand after an injury as well as post-surgically. Finally, there is no comparison to also providing patients with some relief in hearing about your amazing past experiences in working with patients with similar conditions.

HEP accountability and tracking

Helping patients maintain accountability and stay the course for their treatment plan is essential for improving patient outcomes. After all, if they aren’t completing interventions to some extent independently, their progress will likely be slowed. Providing home exercise prescriptions should be seen as just that, a prescription. Patients are prescribed and dosed with exercises by physical therapists in order to improve their condition. Explaining this methodology may be helpful to some patients in order to fully appreciate the importance of completing their home program.

In order to help patients maintain accountability, Prompt has a tracking system that allows the patient and therapist to monitor exercise completion to stay motivated. Just in case the patient needs a gentle reminder on how to perform an exercise provided in the clinic, Prompt’s home exercise program has pictures and videos to guide them.

Consistent follow-up care through appointment management

In order to get patients better, faster, and stronger, they need to attend physical therapy on a regular basis according to their plan of care. This may mean scheduling some post-surgical patients three times per week and others for even daily visits in certain situations.

Prompt helps you and your patients find the time to meet through scheduling management. Not only does Prompt help you ensure patients are scheduled out beyond their initial evaluation for follow-up appointments, but it also provides patient appointment reminders. Life gets busy and it is helpful to have an automated message sent to patients to remind them of upcoming appointments.

Not all patients love coming to therapy as much as you love treating them. For these and others, it can be helpful to give them a small goal to achieve by the next week. Choose something that is a challenge for them, but not impossible. For instance, you may say you want them to be able to advance to the next resistance band level or even achieve a certain strength measurement on an inclinometer. People get excited and motivated to meet and achieve goals. Break their larger more long-term goals down into smaller micro-goals for patients to meet by the next session or next week. This does two things: 1) It increases HEP accountability, and 2) It helps ensure they attend their next session so they can show off their progress!

We hope that by combining these simple yet highly effective communication strategies, you will be able to improve patient outcomes, achieve a higher number of visits, and increase revenue at your practice.

About the author:

Chelsea Krotser is an outpatient orthopedic physical therapist and freelance writer. Drawing on her experience as a PT as well as her former life as an accountant, she is dedicated to providing an insightful clinical and business perspective. She loves writing about all things related to physical therapy. You can find her on Instagram @chelseakrotser.

Prompt Staff

Prompt Therapy Solutions builds practice management software for physical therapy clinics ranging from single provider practices and startups, to large enterprise organizations.

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