Orthotists’ and physical therapists’ perspectives on quality of care indicators for persons with custom ankle-foot orthoses

Abstract

Purpose: To describe the priorities of orthotists and physical therapists about quality measurement themes, and the feasibility and utility of collecting data from persons using custom AFOs that could inform quality measure development. Materials and Methods: Online survey assessed respondents’ perspectives and experiences. An Advisory Committee representing professional, organizational, and accreditor groups distributed survey invitations. Results: 461 orthotists and 153 physical therapists completed part or all of the survey; 60% rated 9 quality themes and 20 quality of care topics as extremely important, and 12 standard instruments as feasible and good to use for quality measurement. Patients were the preferred source of information for ease of scheduling, device weight, ease of donning and doffing, adherence to device use, beneficial effects, activity level and independence, and quality of life. Clinicians were the preferred source for material quality, device modifiability, and joint range of motion. Facility records were the preferred source for timeliness of device delivery and clinician follow-up. Respondents reported that gait speed and walking endurance were best obtained by patient performance. Conclusions: Results provide insight on the topics orthotists and physical therapists regard as priorities for defining healthcare quality for persons using custom ankle-foot orthoses and instruments for data collection.