Outcomes Assessment 5 Reassessment and Outcomes AssessmentRECOMMENDATIONDetermination of the patient's progress must be made on a per-visit and periodic basis. This process provides quantitative and qualitative information regarding the patient's progress which is utilized to determine the frequency and duration of chiropractic care. Per-visit reassessment should include at least one analytical procedure previously used. This chosen testing procedure should be performed each time the patient receives chiropractic care.
Concomitant with this process, the effectiveness of patient care may also be monitored through the development of an outcomes assessment plan. Such a plan may utilize data from the patient examination, assessment and reassessment procedures. Patient-reported quality of life instruments, mental health surveys, and general health surveys are encouraged as part of the outcomes assessment plan. The analysis of data from these sources may be used to change or support continuation of a particular regimen of patient care and/or change or continue the operational procedures of the practice.
Rating: Established
Evidence: E, L
Commentary
The reassessment provides information to determine the necessity of an adjustment on a per-visit basis. Partial reassessment involves duplication of two or more preceding positive analytical procedures. Full reassessment involves duplication of three or more preceding positive analytical procedures. Any additional or complementary analytical procedures should be performed as indicated by the patient's clinical status. The frequency of partial and full reassessments should be at the discretion of the practitioner, consistent with the objectives of the plan of care.
A substantial body of literature attests to the methods and significance of measuring outcomes.(1-100) For the practicing chiropractor the implication is that regular evaluations of practice and procedures provides a form of quality control. Outcomes assessments can alert the practitioner to problems with, as well as reinforce, aspects of practice which might otherwise be overlooked. In addition, on-going evaluation provides information about the clinical value of care to both patients and third-party providers. It is important to point out that there is no one "ideal" way to assess outcomes. While the responsibility to conduct this type of assessment rests with the chiropractor, so does the choice of how it is to be implemented.
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