Evolution of service metrics and utilisation of objective discharge criteria in anterior cruciate ligament reconstructio
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(2020) 10:23
RESEARCH ARTICLE
Open Access
Evolution of service metrics and utilisation of objective discharge criteria in anterior cruciate ligament reconstruction rehabilitation: a retrospective cohort study with historical control in a public hospital physiotherapy department Kirby Tuckerman1, Wendy Potts1, Milad Ebrahimi2, Corey Scholes2
and Mark Nelson1*
Abstract Background: ACL reconstruction (ACLR) is a common procedure requiring rehabilitation in public hospital physiotherapy departments. The rate of re-rupture and reduced rates of return to sport following ACLR are concerning. Current guidelines recommend a progressive approach to rehabilitation based on objective criteria. The aim of this study was to determine whether a new public hospital model of care incorporating a phase-based program increased physiotherapist utilisation of objective outcome measures, improved service metrics including attendance and rehabilitation completion rates, and increased patient-reported activity and knee function. Methods: Records from patients attending outpatient physiotherapy after ACL reconstruction (N = 132) were included in a retrospective chart review to assess utilisation of objective measures such as quadricep and hamstring strength assessment, patient attendance and rehabilitation completion. Phone followup (minimum 1 year) was conducted to retrieve patient-reported measures of knee function (IKDC) and activity (Tegner Activity Scale). Patients were categorised by rehabilitation model of care (contemporary - time based [N = 93] vs new - phase based [N = 39]) and logistic regression used to assess the influence of patient factors and model of care on outcomes. Results: Compliance was equivalent between models of care and completion rates (formal discharge by therapist) were low (30–38%). The probability of a patient receiving objective strength assessment was associated with model of care, sex, BMI and number of sessions attended. The probability of a patient being recorded as discharged from the program was significantly associated with model of care, and duration and number of sessions. (Continued on next page)
* Correspondence: [email protected] 1 Department of Physiotherapy, Queen Elizabeth II Jubilee Hospital, Coopers Plains, QLD, Australia Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exc
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