Contents
- Acknowledgements
- Practice Analysis Task Force
- Introduction
- Executive Summary
- Survey of Practice
- Results Related to Professional Background, Work Setting and Demographic Information
- Results Relating to Domains of Practice
- Results Relating to the Tasks
- Results Related to the Knowledge and Skills Statements
- Results Related to Practice Areas, Devices and Activities
- Qualitative Responses
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Practice Analysis of ABC Certified Assistants in the Disciplines of Orthotics and Prosthetics
January 2012
Results Relating to the Tasks
Respondents rated the tasks using two scales:
- Frequency: How frequently did you perform the task during the past year?
- Criticality: How critical is this task to optimizing outcomes for patients and/or caregivers? 1=Not critical, 2=Minimally critical, 3=Moderately critical, 4=Highly critical
Table 16 provides summary data on the mean Frequency and Criticality ratings for respondents answering the survey from the orthotic and prosthetic perspectives. In the vast majority of cases, there was little difference between the mean Frequency ratings of the respondents in each sub-group: there were only four tasks where the mean difference in rating was 0.4 or greater. In all these instances, the orthotic respondents performed the task more frequently than did the prosthetic respondents. These were Review patient’s prescription/referral and Perform procedure (e.g., measure, take impression, delineate, scan, digitize) (both tasks with a mean rating difference of 0.6), Select appropriate pre-fabricated orthosis based on patient measurements and the established treatment plan (difference of 1.0), and Document all findings and actions related to follow-up using established record-keeping techniques (difference of 0.4).
In only one case was there a mean Criticality rating difference of greater than 0.3 between the orthotic and prosthetic respondents; this was Select appropriate pre-fabricated orthosis based on patient measurements and the established treatment plan (difference of 0.6). As might be expected, the instances wherein the Frequency and Criticality ratings differed the most were associated with sub-group specific tasks.
Table 16
| Frequency | Criticality | |||
|---|---|---|---|---|
| Orthotics | Prosthetics | Orthotics | Prosthetics | |
| Domain 1 – Assessment | ||||
| Review patient’s prescription/referral | 3.7 | 3.1 | 3.7 | 3.4 |
| Review patient history and assessment findings (e.g., previous device use, medical history, physical limitations, activity levels, patient measurements) | 3.5 | 3.4 | 3.7 | 3.7 |
| Consult with certified orthotist/ certified prosthetist about patient’s condition in order to understand the treatment plan (e.g., diagnosis, amputation level, orthotic or prosthetic requirements) | 3.3 | 3.5 | 3.5 | 3.8 |
| Document assessment findings, as directed | 3.7 | 3.5 | 3.7 | 3.7 |
| Domain 2 – Implementation of the Treatment Plan | ||||
| Provide patient with preparatory care for orthotic/prosthetic treatment (e.g., shrinker, compression garment) | 3.0 | 2.8 | 3.3 | 3.5 |
| Select appropriate materials/ techniques in order to obtain a patient model/image | 3.4 | 3.1 | 3.6 | 3.4 |
| Prepare patient for procedure required to initiate treatment plan (e.g., information about aspects of the procedure) | 3.3 | 3.1 | 3.4 | 3.4 |
| Perform procedure (e.g., measure, take impression, delineate, scan, digitize) | 3.4 | 2.8 | 3.7 | 3.5 |
| Select appropriate pre-fabricated orthosis based on patient measurements and the established treatment plan | 3.3 | 2.3 | 3.5 | 2.9 |
| Comply with manufacturer’s specifications regarding components/ materials | 3.6 | 3.7 | 3.6 | 3.8 |
| Prepare delineation/impression/ template for modification/fabrication | 3.3 | 3.3 | 3.6 | 3.6 |
| Rectify and prepare patient model/ image for fabrication | 3.1 | 3.1 | 3.5 | 3.6 |
| Fabricate/assemble/align orthosis/ prosthesis in order to prepare for initial or diagnostic fitting | 3.3 | 3.6 | 3.7 | 3.8 |
| Assess device for structural safety and ensure that manufacturers’ guidelines have been followed prior to patient fitting (e.g., torque values, component weight limits) | 3.5 | 3.7 | 3.7 | 3.9 |
| Assess alignment of orthosis/ prosthesis for accuracy in sagittal, transverse and coronal planes in order to provide optimal function/ comfort | 3.5 | 3.5 | 3.8 | 3.9 |
| Ensure that materials, design and components are provided as specified in the treatment plan | 3.6 | 3.7 | 3.7 | 3.8 |
| Complete fabrication process after achieving optimal fit and function of orthosis/prosthesis (e.g., convert diagnostic device to definitive orthosis/prosthesis) | 3.1 | 3.4 | 3.6 | 3.7 |
| Re-assess orthosis/prosthesis for structural safety at time of delivery | 3.6 | 3.7 | 3.8 | 3.9 |
| Educate patient and/or caregiver about the use and maintenance of the orthosis/prosthesis (e.g., wearing schedules, other instructions) | 3.7 | 3.5 | 3.8 | 3.8 |
| Document treatment using established record-keeping techniques to verify compliance with treatment plan | 3.6 | 3.3 | 3.8 | 3.7 |
| Domain 3 - Follow-up of the Treatment Plan | ||||
| Obtain feedback from patient and/or caregiver to evaluate outcomes (e.g., wear schedule/tolerance, comfort, ability to don and doff, proper usage and function) | 3.4 | 3.3 | 3.6 | 3.7 |
| Assess patient’s general health, including physical status, skin condition, height and weight | 3.4 | 3.3 | 3.6 | 3.7 |
| Assess patient’s psychosocial status (e.g., family status, job or caregiver) | 3.0 | 2.9 | 3.1 | 3.2 |
| Assess fit and function of orthosis/ prosthesis to determine need for changes to meet goals of the established treatment plan | 3.5 | 3.3 | 3.8 | 3.7 |
| Assess patient’s achievement of planned treatment goals | 3.2 | 3.0 | 3.5 | 3.5 |
| Inform certified orthotist/certified prosthetist of all findings that affect the treatment plan | 3.4 | 3.6 | 3.6 | 3.8 |
| Adjust orthosis/prosthesis to meet goals of treatment plan | 3.5 | 3.4 | 3.7 | 3.7 |
| Assess adjusted orthosis/prosthesis for structural safety | 3.6 | 3.4 | 3.8 | 3.7 |
| Evaluate results of adjustments to orthosis/prosthesis, including static and dynamic assessment | 3.4 | 3.3 | 3.6 | 3.7 |
| Educate patient to ensure continued proper use of adjusted orthosis/ prosthesis | 3.5 | 3.3 | 3.8 | 3.7 |
| Document all findings and actions related to follow-up using established record-keeping techniques | 3.7 | 3.3 | 3.8 | 3.6 |
| Domain 4–Practice Management | ||||
| Comply with all applicable federal, state and local laws and regulations (e.g., CMS, HIPAA, FDA, ADA, OSHA, state licensure) | 3.9 | 3.9 | 3.9 | 3.9 |
| Adhere to professional and ethical guidelines (e.g., ABC Code of Professional Responsibility) | 3.9 | 4.0 | 3.9 | 4.0 |
| Comply with established documentation requirements related to patient billing and claims development | 3.7 | 3.5 | 3.8 | 3.8 |
| Promote a safe and professional environment for patient care (e.g., universal precautions, ABC Facility Accreditation standards) | 3.9 | 3.9 | 3.9 | 3.9 |
| Domain 5–Promotion of Competency and Enhancement of Professional Practice | ||||
| Maintain competence by participating in continuing education | 3.1 | 3.2 | 3.6 | 3.6 |
| Participate in education of residents, students and staff | 2.8 | 3.1 | 3.3 | 3.5 |
| Participate in product development research, clinical trials and outcome studies | 2.1 | 2.2 | 2.9 | 3.1 |
| Participate in the development, implementation and monitoring of public policy regarding orthotics/ prosthetics (e.g., provide testimony/ information to legislative/regulatory bodies, serve on professional committees and regulatory agencies) | 1.7 | 1.6 | 2.8 | 2.9 |
| Promote public awareness of the profession | 2.5 | 2.7 | 3.0 | 3.2 |
