Open AccessAn exploratory qualitative study of health professional perspectives on clinical outcomes in UK orthotic practice
Author(s) -
Hall Natalie,
Parker Daniel,
Williams Anita
Publication year - 2020
Publication title -
journal of foot and ankle research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.763
H-Index - 39
ISSN - 1757-1146
DOI - 10.1186/s13047-020-00416-w
Subject(s) - thematic analysis , focus group , medicine , data collection , qualitative research , outcome (game theory) , health care , medical education , nursing , medline , compromise , delegation , qualitative property , exploratory research , social science , statistics , mathematics , mathematical economics , marketing , machine learning , sociology , political science , economics , computer science , anthropology , law , business , economic growth
Background Despite potential savings to the National Health Service, the collection of data on outcomes of NHS orthotic services is patchy. Indeed, several reports into orthotic services in the UK have reported a lack of data relating to outcomes of care and highlighted the need to routinely measure outcomes to demonstrate efficacy of services. Whilst a previous study provided an overview of the use of outcome measures in orthotic practice and identified some barriers to their use, further questions emerged. Hence, this qualitative study aimed to explore orthotists' opinions and personal experiences on the influences on outcomes, how appropriate and relevant outcomes can be measured and also how barriers to the use of outcome measures can be overcome. Methods Following a review of the literature , an initial advisory group informed semi‐structured questions. These were used to create dialogue in a focus group of 12 orthotists. Data from the focus group was transcribed verbatim and analysed using thematic analysis, creating themes and subthemes for discussion. Results The setting of realistic and agreed goals through managing expectations, compromise and patient education/information were seen as factors that could inform and improve outcomes. Barriers to the collection of outcome measures were associated with inadequate technology to manage the data, lack of time to complete them, lack of training in them and difficulties selecting appropriate outcome measures for patients with complex problems managed by different health professionals. The participants discussed ways of addressing these barriers, such as the use of ‘snapshots' and delegation of data collection. Conclusions This study has revealed that measuring outcomes is considered to be an important activity. In order to achieve good outcomes, it is important to address patient expectations, discuss and establish joint goals for care at the outset and inform and include patients in the decision‐making process. The identified barriers to measuring outcomes can be overcome with the solutions revealed by these participants. Hence, this study has contributed to current knowledge which has relevance for clinical practice and may provide the theoretical basis for future research.