S283 S290
Index Measure (FIM) change of those admitted patients; Length of stay
(LOS) efficiency; discharge disposition of the admitted patients;
Results:
Twelve months before intervention (4/1/15-3/31/16), 14
trauma patients representing 4 rehabilitation impairment group
codes were admitted. On rehab discharge, they had a mean LOS of
18.3 days, mean FIM change of 30.8 points, LOS efficiency of 1.92
points/day, and disposition 50% home, and 50% to nursing home or
acute care. Twelve months after the intervention (4/1/16-3/31/17),
42 trauma patients representing 11 rehabilitation impairment group
codes were admitted. Upon discharge, they had a mean LOS of 15.7
days, mean FIM change of 38.2 points, LOS efficiency of 3 points/
day, and disposition 93.0% home, and 7% to nursing home or acute
care.
Conclusions:
Implementation of a multi-component physiatry-centric
intervention within a level one trauma system of care is associated
with a greater number and diversity of patients served, an
improvement in function per day, and more patients discharged
home. There was a statistically significant increase in: LOS efficiency
(P
¼
.025), discharge FIM (P
¼
.032) and community disposition after
discharge (P
¼
.001).
Level of Evidence:
Level IV
CATEGORY: QUALITY IMPROVEMENT
Poster 473:
The Power is in Your Hand(out)
d
Improving Patient
Compliance and Satisfaction Through Implementation of an
After-Visit Handout: A Quality Improvement Project
Jared T. Aida, DO (Loma Linda Univ, Loma Linda, CA, United States),
Mary Kim, MD, Sarah E. Humbert, MD
Disclosures:
Jared Aida: I Have No Relevant Financial Relationships To
Disclose
Objective:
To assess whether the implementation of an after-visit
handout would improve patient treatment plan compliance and pa-
tient satisfaction.
Design:
Quality improvement study.
Setting:
Outpatient musculoskeletal clinic in an academic center.
Participants:
77 patients and 14 physicians completed questionnaires
before implementing the intervention. 59 patients and 9 physicians
completed questionnaires following implementation of the intervention.
Interventions:
A two-sided handout was designed and distributed to
patients at the close of each clinic visit. On one side was a list of
various treatment options (i.e. injections, therapies, walking aids,
braces, etc.) which the physician could customize for each patient’s
treatment plan. On the other side were instructions on how to access
the aforementioned treatment options, including pertinent phone
numbers and addresses. Patients were surveyed before and following
handout usage to ascertain any changes in patient compliance or
satisfaction. Physician staff was similarly surveyed before and
following handout usage, regarding their confidence in patient
compliance to the treatment plan.
Main Outcome Measures:
An anonymous, self-reported questionnaire
consisting of Likert-type questions. Participants graded various state-
ments on a scale of 1 through 5 (1 for “strongly disagree,” 5 for
“strongly agree”). The statements acted as surrogate measures of
patient understanding and compliance of treatment plans, as well as
patient knowledge of how to access services.
Results:
All survey scores from the patient group and physician group
improved with the use of the handout. Data analysis showed statisti-
cally significant (P
<
.05) improvement in all patient measures.
Physician confidence in patients’ memory of the plan and knowledge
of how to access services also improved significantly (P
<
.05).
Conclusions:
The implementation of an after-visit handout which
outlines the customized treatment plan and directions on how to ac-
cess treatment services may result in improved patient compliance
and satisfaction. Similarly, it may improve timeliness of care and care
delivery efficiency.
Level of Evidence:
Level III
CATEGORY: GENERAL REHABILITATION
Poster 474:
Development of a Return to Work Tool for Primary
Care Providers for Low Back Pain Patients: Pilot Study
Assessment
Aishwarya Raja, BS (New York, NY, United States), Parth D. Trivedi,
MS2, Ismail Nabeel, MD
Disclosures:
Aishwarya Raja: Ownership or partnership - CatheCare
LLC
Objective:
To assess a pilot study aimed at developing return-to-work
(RTW) guidelines in the form of an accessible and adaptable Electronic
Medical Records (EMR) integrated tool.
Design:
Randomized, controlled study.
Setting:
Primary care offices.
Participants:
73 licensed PCPs who see patients over the age of 18
years, presenting with acute low back pain (LBP), and are currently
employed. PCPs were randomized with (n
¼
40) and without (n
¼
33) the
RTW guidelines.
Interventions:
We developed and integrated RTW guidelines for LBP
into Epic EMR. Personalized messages were sent to PCPs outlining
missed opportunities to offer RTW recommendations to patients pre-
senting with acute LBP.
Main Outcome Measures:
Using ICD10 codes to identify patients with
LBP, charts were data mined to assess if PCPs made recommendations
regarding RTW.
Results:
PCPs frequently encounter patients with LBP (900+ visits
related to LBP-related diagnosis and 250+ visits to lumbar-related
disorders) and use about 50 ICD10 codes to identify this diagnosis. 99.8%
of visits to the control group had not discussed the RTW option with
patients suffering from LBP while 2.8% of visits of the interventional
group had discussed this option with patients suffering from LBP. The
interventional group had a higher probability (P-value
¼
.00201784) of
recommending RTW options compared to the control group.
Conclusions:
Despite the frequency in which they treat patients with
low back pain, PCPs rarely offer RTW recommendations. Our pre-
liminary results suggest that PCPs with the integrated tool offering RTW
guidelines were more likely to provide patients with recommendations.
The pilot study underscores the importance of disseminating practice
guidelines in an accessible manner to facilitate adoption by clinicians.
The next step is to extract a subset of patient visits in order to train a
ML algorithm that will better differentiate low back pain types, such as
acute, acute on chronic, or chronic, and improve the tool’s efficacy.
Level of Evidence:
Level II
CATEGORY: QUALITY IMPROVEMENT
Poster 475:
Improving Patient Care: Resident Pocket Guide
and Handouts of Therapeutic Exercises for Common
Musculoskeletal (MSK) Disorders for Patients in an Outpatient
Indigent PM&R Clinic
Katherine Lin, MD (Jackson Mem Hosp/Jackson Hlth Sys, Miami,
Florida, United States), Huy N. Nguyen, MD, Andrew L. Sherman, MD,
FAAPMR
Disclosures:
Katherine Lin: I Have No Relevant Financial Relationships
To Disclose
S283
Abstracts / PM R 9 (2017) S131-S290