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Practice Analysis of ABC Certified Mastectomy Fitters

January 2019


Appendix C

Linking Study
 Tasks  Knowledge and Tasks
 1. Patient AssessmentK/S   1K/S   2K/S  3K/S  4K/S 5K/S 6
1Review patient's prescription/referralk11k7k1k9k23 
2Obtain relevant patient medical history, including previous use of post- mastectomy items, diagnosis, and activities of daily living (ADL)k12s33s39   
3Discuss patient's expectations and goalss33s35s36   
4Perform a diagnosis-specific functional clinical examination that includes observation of chest wall and evaluation of range of motion, manual dexterity, skin integrity, and shape/physical characteristicsk2k3k4k5s33s34
5Consult with other healthcare professionals and caregivers about patient's condition, as neededk11k20k19   
6Refer patient, if appropriate, to other healthcare professionals (e.g., therapist, physician) for intervention beyond mastectomy fitter's scope of practicek20k14k19   
 2. Formulation of Treatment Plan      
1Use the assessment results to formulate a treatment plan, including goals and expected outcomes to increase patient comfort, enhance function, accommodate deformity (e.g., shoulder drop, scoliosis) and improve balance, symmetry and appearances34k8s35s36  
2Consult with licensed healthcare prescriber to obtain supporting documentation and/or modify the original prescription, if necessaryk12k14k11k32  
3Document the patient's need described in the treatment plank12k32s39s36  
4Identify post-mastectomy items to support the treatment plans37k21k22   
5Communicate to patient and/or caregiver about the recommended treatment plan and timeline for completions38k32s33   
6Inform patient or responsible parties of their financial responsibilities as they pertain to the recommended treatment plan and/or any coverage limitationsk15k32    
 3. Implementation of Treatment Plan      
1Select and prepare appropriate post-mastectomy items to implement treatment plank21s37k28   
2Assess fit and comfort of post- mastectomy items and make any necessary adjustmentsk24k22s38s36  
3Ensure that post-mastectomy items are provided as prescribedk32s39k12   
4Educate patient and/or caregiver about the use and care of post-mastectomy items (e.g., wearing schedules, cleaning), including benefits, possible risks, and warranty informationk25k26k28   
5Advise the patient and/or caregiver about their rights and responsibilitiesk32k18k13   
6Document treatment using established record-keeping techniques to verify implementation of treatment plans39k12k32   
7Develop and communicate follow-up plans36s37    
 4. Follow-up 
1Obtain feedback from patient and/or caregiver about the outcome of the treatment plan (e.g., tolerance, comfort, ability to don and doff, proper usage and function)s33s34    
2Re-evaluate the patient through a follow-up clinical examination that may include review of changes to patient status, shape, and physical characteristicss33s34s36   
3Identify need for changes relative to initial treatment goals and expectations by assessing fit of post-mastectomy itemss38k22    
4Modify or adjust post-mastectomy items based on assessment and/or patient/caregiver feedbackk22s38    
5Educate patient and/or caregiver on proper use of post-mastectomy items relative to modifications/adjustments k21k25s36   
6Document follow-up care, including any changes in treatment plank12s39    
 5. Practice Management      
1Comply with federal and state regulations for the delivery of items within the Certified Mastectomy Fitter Scope of Practice (e.g., CMS, Medicaid, OSHA, HIPAA)k32s39k16k15  
2Comply with policies and procedures regarding universal precautions and infection controlk32k17    
3Comply with documentation requirements (e.g., document retention, verification that post-mastectomy items were delivered and billed as prescribed)k12s39k32