Practice Analysis of ABC Certified Orthotic Fitters

January 2019

Tasks

Results and Discussion Related to the Tasks

This section presents the results of the ratings related to the 32 tasks delineated in the survey. All survey respondents rated the tasks using two scales:

Frequency: How frequently did you perform the task during the past year? 1=Never or rarely, 2=Occasionally, 3=Frequently, 4= Very frequently
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 15 shows the mean Frequency and Criticality ratings of tasks for respondents. The two highest rated tasks are found in the Implementation of the Treatment Plan domain: Ensure that device and components are fit and delivered as prescribed and Educate patient and/or caregiver about the use of/maintenance of the orthosis (e.g., wearing schedules, donning/doffing, other instructions). Both of these tasks received a mean Frequency rating of 3.8. Only one task received a mean Frequency rating below 2.5 – Participate in/with consumer organizations and nongovernmental organizations to promote competency and enhancement of orthotic profession.

All tasks were quite highly rated as being critical to optimizing outcomes for patients and/or caregivers. The two tasks that were the most highly rated on the Frequency scale were also most highly rated on the Criticality scale, with mean ratings of 3.9 for each. No tasks were rated below a mean of 2.5 on the Criticality scale, and only one task received a mean criticality rating of lower than 3.0. As on the Frequency scale, that was Participate in/with consumer organizations and nongovernmental organizations to promote competency and enhancement of orthotic profession; even so, this task was rated as very close to moderately critical.

These ratings indicate that the tasks identified in the practice analysis are well targeted to identify the essential activities that comprise the practice of orthotic fitters. The pattern of Frequency and Criticality ratings validates the use of these tasks in initiatives related to item writing and examination development.

Table 15

Task Frequency and Criticality
Task - Patient Assessment	Frequency	Criticality
Review patient’s prescription/referral	3.7	3.8
Take a patient history (e.g. previous device use, medical history, physical limitations, activity levels)	3.5	3.7
Perform a clinical assessment based on prescription and diagnosis	3.4	3.6
Communicate to patient and/or caregiver about the recommended treatment plan	3.6	3.7
Consult with other healthcare professionals and caregivers about patient's condition	2.9	3.3
Refer patient, if appropriate, to other healthcare professionals (e.g., orthotist, physician) for intervention beyond orthotic fitter scope of practice	2.5	3.4
Task - Formulation of the Treatment Plan
Determine the appropriate device recommendation based on the prescription	3.5	3.8
Formulate treatment goals and expected outcomes (e.g. reduce pain, provide support, increase function, prevent deformity)	3.2	3.5
Consult with physician/referral source to modify, if necessary, the original prescription and/or treatment plan	2.6	3.5
Identify material and device design to support anticipated outcome	3.2	3.4
Develop a plan for patient needs, including patient education and follow-up (e.g. precautions, appropriate use, device hygiene)	3.4	3.6
Inform patient or responsible parties of their financial responsibilities as they pertain to proposed treatment plan	3.2	3.4
Task - Implementation of the Treatment Plan
Inform patient, family and/or caregivers regarding orthotic treatment plan, including procedure, time involved, and possible risks	3.3	3.6
Select appropriate device required to implement treatment plan	3.5	3.7
Take appropriate measurements and cross reference measurements to manufacturer’s guidelines	3.7	3.7
Consult manufacturer’s device guidelines (e.g. recommended use, limitations, care, structural safety)	3.3	3.5
Assess fit and function of device in sagittal, transverse, and coronal planes	3.4	3.6
Ensure that device and components are fit and delivered as prescribed	3.8	3.9
Instruct patient on manufacturer’s warranty	3.2	3.2
Educate patient and/or caregiver about the use of/maintenance of the orthosis (e.g., wearing schedules, donning/doffing, other instructions)	3.8	3.9
Document treatment to verify delivery, use, care, and precautions	3.7	3.8
Task - Follow-up Treatment Plan
Determine patient’s compliance (e.g., wearing schedule, proper usage and function, patient satisfaction)	3.0	3.4
Reassess patient’s functional level, skin condition, general health	2.9	3.4
Determine need for changes to device by assessing fit	2.9	3.4
Adjust device based on assessment and inform patient and/or caregiver of changes	2.9	3.5
Evaluate results of modifications	3.0	3.5
Inspect device for signs of material fatigue or excessive wear that may lead to product failure	2.9	3.4
Task - Practice Management
Consider requirements of federal compliance regulations for the delivery of device within the Orthotic Fitter Scope of Practice (e.g. Medicare, HIPPA, L-codes, documentation requirements)	3.6	3.7
Consider requirements of state compliance regulations for the delivery of device within the Orthotic Fitter Scope of Practice (e.g. Medicaid, licensure)	3.5	3.7
Utilize procedures for universal precautions and disposal of bio-hazardous materials	3.2	3.7
Task - Promotion of Competency and Enhancement of Professional Practice
Participate in continuing education and/or provide such education for other orthotic or healthcare professionals	2.8	3.5
Participate in/with consumer organizations and nongovernmental organizations to promote competency and enhancement of orthotic profession	2.1	2.9

Frequency values: 1=Never / rarely, 2=Occasionally, 3=Frequently, 4= Very frequently

Criticality values: 1=No critical, 2=Minimally critical, 3=Moderately critical, 4=Highly critical

Contents

Practice Analysis of ABC Certified Orthotic Fitters

Tasks

Results and Discussion Related to the Tasks