Over the past several months, I’ve talked a lot about how therapists can prove their value (namely, through tracking outcomes data). But, even though data provides the value proof we need, it’s not the end of the story. It’s up to us to turn that data into something meaningful—something we can act on that will actually help us demonstrate the value of our care. And that means using data in conjunction with defensible documentation to inform our treatment decisions and hold ourselves accountable to meeting high standards of care quality.
Good patient documentation—the kind that paints a complete picture of each patient and his or her therapy journey—should clearly show progress and highlight improvement in an accurate and concise way. It should focus on the most important pieces of information that add color—and more importantly, meaningful context—to your patients’ stories. But, those stories should read more like CliffsNotes than lengthy novels. The content should be easily digestible, make a clear statement, and highlight only the most important and relevant details. Furthermore, to make each story believable, you must root the details you include in fact. That’s where outcomes data comes in.
The Main Character
If you want to tell a story that proves the efficacy of your care, you can’t forget the most important component: your main character (i.e., your patient). So, how do you effectively tell an individual patient’s story? What actions do you need to take to ensure your documentation reflects your patient and his or her previous functional level, current status, and therapy progress in the most accurate, complete way possible? Here’s what you need to do:
When you listen to your patients, you’ll hear their exact complaints and expectations. And if you listen close enough, you’ll often discover that what they don’t expressly say actually provides better insight into their feelings and experiences. For example, you might notice that this week, a patient didn’t bring up a particular symptom that he or she mentioned last week. Does that mean the patient is improving? Possibly. But, picking up on this potentially insightful omission is only step one; now, it’s time to ask the right questions to tease out the facts. Just make sure you steer clear of any leading questions; after all, you don’t want to force your projected outcome on the patient. So, focus on listening to the patient first—before you interject with your own ideas or analysis.
Speaking of objectivity, as you document what you’re hearing, seeing, and inferring from visit to visit, be sure to note any changes in pain levels and patient goals. Patient-reported outcomes—that is, outcomes tools that incorporate patients’ responses to questionnaires—can help you track those changes in a non-subjective way. When you administer these tests consistently, you’ll have specific data points to help illustrate patient progress, make measurable and accurate comparisons, and draw meaningful conclusions about treatment effectiveness and patient satisfaction levels.
If you administer patient outcomes questionnaires and you notice a patient isn’t filling them out completely, find out why. Is it because the questions are uncomfortable? Is the survey unclear? Or, perhaps the patient simply doesn’t understand how the questionnaire fits into his or her overall treatment picture. Whatever the reason, I encourage you to sit with the patient and talk through any questions he or she might have. It’s also paramount to explain the value of filling out the questionnaire as honestly as possible.
Now that we’ve covered the importance of listening, asking questions, and following through, I want to talk about patient satisfaction as it relates to your practice setting. Every dynamic character interacts with his or her setting. Bearing that in mind, are you providing the best possible quality in all aspects of your business? Is your outcomes data telling you that your patients are happy? If the data shows that your patient satisfaction scores are down, you better find out what’s causing that dissatisfaction. In some cases, the answer might be something as simple as the treatment environment.
When it comes to treatment environment, I really want to emphasize how important it is that you have a pulse on your clinic’s communication. The way you and your staff communicate with your patients as well as with each other can greatly impact your patients’ perception of care. And your patients’ perception of care—as you know—is extremely important. In this web presentation, David Browder and Larry Benz cover the care factors that actually matter to patients. And they found that the patients with the highest satisfaction levels had the following opinions in common:
- their therapist was knowledgeable,
- they received clear instructions,
- the appointments began on time,
- the staff was friendly, and
- their own physician recommended the clinic.
So, as you keep those five things in mind, I also encourage you to evaluate the flow of your patient appointments. For example, if things in your clinic tend to be fairly chaotic, it could be stressing out your patients. And if you discover that’s the case, you can address the issue before it negatively affects more patients’ experiences. This is one example of how outcomes questionnaires—and patient satisfaction surveys, in particular—provide a great opportunity for you to pinpoint problems in your practice that you wouldn’t have otherwise been aware of (unless you received a poor patient review on Yelp or another online platform).
Just as tracking outcomes helps you write the best possible report for your patients, your data allows you to set the course for your own story. Specifically, it empowers you to confidently negotiate your payer contracts (and work toward getting the rates you deserve), become a referral engine, and demonstrate to your patients why you’re the best provider to address their needs. Now, that doesn’t mean you can simply spit out the numbers and move on with your life. You have to take a hard look at what your scores mean, carefully considering all of the factors that may influence your outcomes data. Ask yourself:
- Are you routinely administering the tests?
- How are you tracking and using the responses/results?
- Are your therapists trying to influence what should be patients’ honest opinions?
Once you’ve accounted—and adjusted—for all of these factors, you can be sure the data you’re using to drive your decision-making is truly reliable. And the key is that you actually are using it. (For some helpful tips on how to incorporate outcomes data into both your business and clinical operations, check out this blog post.)
I’d argue that we, as rehab therapists, are all interested in contributing to the greater good. By and large, we truly want to improve the lives of people everywhere—whether or not they’re our patients. And that’s exactly what tracking and acting on outcomes data can help us do—if we’re willing to band together and pool our data, that is. After all, the more measurable, accurate, and risk-adjusted data we can collect and leverage, the more strongly we can assert our value as healthcare providers.
Part of asserting our value is having the courage to make changes based on what we discover through collecting data. It’s crucial that we remain open-minded and take swift action to improve our care, which in turn can help our patients get better, faster. Remember, it’s the patients who quickly improve and experience exceptional care that leave great reviews and generate more business through word of mouth. As in the book world, the more positive reviews we have, the more potential we have to gain new business. And isn’t that the happy ending we all want to write?
Now, it’s your turn to finish the story. What will you do with your outcomes data? Will you take the steps necessary to turn data into action? Share your thoughts in the comment section below.