Contents
- Acknowledgements
- Practice Analysis Task Force
- Introduction to a Practice Analysis
- Executive Summary & Results Highlights
- Survey Return Rate
- Results Related to Professional Background, Demographic Information and Work Setting
- Results Related to Domains, Tasks, Knowledge and Skill Statements
- Domains
- Tasks
- Knowledge and Skill Statements
- Orthotic Practice Areas and Orthoses
- Prosthetic Practice Areas and Devices
- Methodology
©2024 by the American Board for Certification in Orthotics, Prosthetics & Pedorthics, Inc. All rights reserved.
No part of this document may be produced in any form without written permission of the American Board for Certification in Orthotics, Prosthetics & Pedorthics, Inc.
Practice Analysis of Certified Practitioners in the Disciplines of Orthotics and Prosthetics
September 2022
Tasks
This section documents the quantitative ratings of the respondents on the task statements delineated in association with each of the six domains as well as the qualitative comments regarding the comprehensiveness of the delineation. All survey respondents rated the tasks on two rating scales:
Table 22
| Frequency On average, how frequently do YOU perform the task in YOUR current position? | Importance How important is this task for a NEWLY CERTIFIED orthotist’s and/or prosthetist’s job performance? |
|---|---|
| 0 = Never/not applicable | 0 = Of no importance |
| 1 = Quarterly or less | 1 = Of little importance |
| 2 = Monthly | 2 = Of moderate importance |
| 3 = Weekly | 3 = Important |
| 4 = Daily | 4 = Very important |
A summary of task importance and frequency means is provided in Table 23. It should be noted that frequency is not necessarily related to importance: A task may be done infrequently but considered highly important, or it may be done frequently but considered less important.
Table 23
| Frequency | Importance | |||
|---|---|---|---|---|
| O | P | O | P | |
| Domain 1—Patient Evaluation | ||||
| 1. Review patient’s prescription/referral | 3.8 | 3.6 | 3.9 | 3.8 |
| 2. Take a comprehensive patient history, including demographic characteristics, family dynamics, previous use of an orthosis/prosthesis, diagnosis, work history, avocational activities, signs and symptoms, medical history (including co-morbidities, surgeries, allergies, current medications, fall history and risk), reimbursement status, patient compliance with ancillary care, results of diagnostic evaluations | 3.7 | 3.5 | 3.8 | 3.7 |
| 3. Ascertain patient and/or caregiver goals and expectations | 3.7 | 3.5 | 3.8 | 3.8 |
| 4. Perform a diagnosis-specific clinical, functional and cognitive examination (e.g., manual muscle testing, gait analysis, anatomy, range of motion, joint stability, skin integrity, sensory function) | 3.6 | 3.4 | 3.7 | 3.7 |
| 5. Administer outcome measures to determine a baseline (e.g., pain scales, timed walking tests, functional mobility tests, validated questionnaires) | 2.4 | 2.7 | 2.9 | 3.2 |
| 6. Consult with other healthcare providers and caregivers, as appropriate, about patient’s condition to formulate a treatment plan as a part of the comprehensive plan of care | 3.1 | 3.0 | 3.4 | 3.4 |
| 7. Document the findings of the patient evaluation using established record-keeping requirements | 3.8 | 3.6 | 3.9 | 3.8 |
| 8. Refer patient, if appropriate, to other healthcare providers for intervention beyond orthotic/prosthetic scope of practice | 2.5 | 2.6 | 3.1 | 3.3 |
| Domain 2—Formulation of the Treatment Plan | ||||
| 1. Analyze the findings of the patient evaluation | 3.7 | 3.5 | 3.8 | 3.8 |
| 2. Formulate treatment goals based on expected orthotic/ prosthetic outcomes (e.g., reduce pain, provide stability, prevent deformity and/or promote healing to enhance function and independence) | 3.7 | 3.5 | 3.8 | 3.8 |
| 3. Communicate with the referral source to modify, if necessary, the original prescription and/or treatment plan | 2.8 | 2.7 | 3.4 | 3.4 |
| 4. Investigate treatment options by obtaining evidence from the literature to formulate the treatment plan | 2.1 | 2.1 | 2.9 | 2.9 |
| 5. Develop a treatment plan which includes patient education and follow-up based on patient evaluation, medical necessity, aesthetic considerations, patient’s goals and expectations and treatment goals | 3.6 | 3.4 | 3.7 | 3.7 |
| 6. Identify design, materials and components needed to implement the treatment plan | 3.7 | 3.5 | 3.7 | 3.7 |
| 7. Discuss with the patient and/or caregiver about the recommended treatment plan(s), including disclosure of potential risks, benefits and limitations in orthotic or prosthetic care | 3.7 | 3.5 | 3.8 | 3.8 |
| 8. Document treatment plan specifying medical necessity according to established record-keeping requirements | 3.7 | 3.5 | 3.8 | 3.8 |
| 9. Ensure that patient or responsible parties are informed of their financial responsibilities (e.g., insurance eligibility, verification of benefits, prior authorization, deductibles) as they pertain to recommended treatment plan(s) | 3.0 | 2.9 | 3.2 | 3.3 |
| 10. Communicate recommended treatment plan to the patient's health care team | 2.9 | 2.8 | 3.1 | 3.2 |
| Domain 3—Implementation of the Treatment Plan | ||||
| 1. Provide patient with care to prepare them for orthotic/ prosthetic treatment (e.g., diagnostic device, compression garment, shrinker) | 3.0 | 3.3 | 3.5 | 3.7 |
| 2. Inform patient and/or caregiver(s) of the measurement/shape capture technique, including the possible risks and time involved | 3.5 | 3.2 | 3.4 | 3.3 |
| 3. Select and perform measurement/ shape capture technique (e.g., identify anatomical landmarks, measure, take impression, trace limb, digital scan) | 3.7 | 3.4 | 3.9 | 3.9 |
| 4. Refer to manufacturer’s specifications and other technical resources regarding components/materials | 2.9 | 2.9 | 3.4 | 3.4 |
| 5. Select appropriate materials and components for orthosis/prosthesis based on patient criteria to ensure optimum strength, durability and function (e.g., orthotic joints, prosthetic components and lamination or thermoforming techniques) | 3.6 | 3.4 | 3.8 | 3.8 |
| 6. Create and/or modify positive or digital model for fabrication (e.g., fill cast, carve positive model, reverse tracing) | 2.8 | 3.3 | 3.4 | 3.8 |
| 7. Fabricate and/or assemble orthosis/prosthesis prior to initial or diagnostic fitting | 2.7 | 3.0 | 3.3 | 3.5 |
| 8. Assess the item for structural safety and ensure that manufacturers’ guidelines have been followed prior to fitting and delivering the device to the patient (e.g., torque values, patient weight limits) | 3.5 | 3.4 | 3.8 | 3.8 |
| 9. Perform initial fitting, assessment and alignment of orthosis/prosthesis in sagittal, transverse and coronal planes to achieve maximum function and ensure patient safety | 3.7 | 3.5 | 3.9 | 3.9 |
| 10. Finalize orthosis/prosthesis fabrication after achieving optimal fit and function (e.g., convert diagnostic device/socket to definitive orthosis/ prosthesis) | 3.1 | 3.0 | 3.6 | 3.6 |
| 11. Ensure that materials, design, and components are provided as specified in the treatment plan | 3.6 | 3.4 | 3.7 | 3.7 |
| 12. Administer Outcome Measure(s) at delivery and compare to baseline value(s) | 2.3 | 2.5 | 3.0 | 3.1 |
| 13. Educate patient and/or caregiver(s) about the use and maintenance of the orthosis/prosthesis (e.g., wear schedules, care instructions) | 3.8 | 3.5 | 3.9 | 3.9 |
| 14. Ensure teh patient's ability to wear and use the orthosis/prosthesis | ||||
| 15. Refer patient to appropriate healthcare providers for necessary ancillary care | 3.8 | 4.1 | 3.3 | 3.5 |
| 17. Document treatment and outcomes using established record-keeping requirements to verify implementation of treatment plan | 4.7 | 4.6 | 3.7 | 3.7 |
| Domain 4—Follow-up to the Treatment Plan | ||||
| 1. Obtain feedback from patient and/or caregiver to evaluate outcome (for example, adherence to wear schedule, comfort, perceived benefits, perceived detriments, ability to don and doff, proper usage and function, overall patient satisfaction) | 4.4 | 4.5 | 3.7 | 3.7 |
| 2. Assess patient’s current function and any changes in the patient's condition (e.g., skin condition, volume, general health, height, weight) | 3.5 | 3.3 | 3.7 | 3.8 |
| 4. Review the patient’s psychosocial status (e.g., family status, job or caregiver) | 2.8 | 2.8 | 3.0 | 3.1 |
| 5. Evaluate the fit of orthosis/prosthesis relative to anatomical accuracy (e.g., multiple force systems, total contact) | 3.7 | 3.4 | 3.9 | 3.8 |
| 5. Evaluate the alignment and function of orthosis/prosthesis relative to treatment goals (e.g., segmental relationships, dynamic alignment) | 3.6 | 3.4 | 3.8 | 3.8 |
| 6. Inspect the structural integrity of the orthosis/prosthesis | 3.6 | 3.6 | 3.8 | 3.8 |
| 7. Evaluate the patient’s progress toward treatment goals | 3.2 | 3.0 | 3.5 | 3.5 |
| 8. Formulate and inform patient and/or caregiver of the plan to modify orthosis/prosthesis based on patient feedback and observations | 3.4 | 3.1 | 3.7 | 3.6 |
| 9. Modify orthosis/prosthesis (e.g., relieve pressure, change range of motion, adjust alignment, exchange components) and reassess device for structural safety | 3.6 | 3.4 | 3.8 | 3.8 |
| 10. Evaluate the results of modifications and ability of the patient to wear and use the orthosis/prosthesis | 3.6 | 3.3 | 3.8 | 3.8 |
| 11. Administer Outcome Measure(s) and compare to baseline value(s) | 2.2 | 2.4 | 2.9 | 3.0 |
| 12. Develop follow-up plan and communicate with patient and/or caregiver(s) | 3.4 | 3.2 | 3.5 | 3.6 |
| 13. Document findings, actions and follow-up plan according to established record keeping requirements | 3.7 | 3.4 | 3.7 | 3.7 |
| 14. Communicate changes in patient’s condition or treatment plan to their health care team | 2.8 | 2.7 | 3.3 | 3.3 |
| Domain 5—Practice Management | ||||
| 1, Adhere to organizational policies and procedures in compliance with all applicable federal and state laws and regulations and professional and ethical guidelines (e.g., CMS, False Claims Act, Start Law, Anti-Kickback Statute, HIPAA, FDA, OSHA, O&P licensure) | 3.8 | 3.7 | 3.7 | 3.6 |
| 2. Comply with ABC ethical and facility guidelines (e.g., Code of Professional Responsibility, Facility Accreditation Standards) | 3.8 | 3.8 | 3.7 | 3.7 |
| 3. Comply with professional guidelines including management and supervision of care extenders (i.e., ABC Scope of Practice | 3.7 | 3.7 | 3.6 | 3.6 |
| 4. Develop and implement personnel policies and procedures (e.g., employee orientation, diversity and inclusion, sexual harassment, benefits, training, incentives, recognition, regular performance evaluations) | 3.0 | 3.1 | 2.4 | 2.5 |
| 5. Adhere to policies and procedures for patient care that comply with current medical, legal and third-party reimbursement requirements | 3.7 | 3.8 | 3.7 | 3.5 |
| 6. Document patient clinical notes and financial records according to established record-keeping requirements | 3.8 | 3.8 | 3.7 | 3.5 |
| 7. Create a professional and collaborative working environment to improve patient care | 3.7 | 3.7 | 3.6 | 3.5 |
| 8. Use data to analyze current practices and identify opportunities for performance and quality improvement | 3.0 | 3.1 | 2.3 | 2.5 |
| Domain 6—Promotion of Professional Practice | ||||
| 1. Participate in or provide continuing education for orthotists, prosthetists and other healthcare providers through activities such as seminars, case studies and authoring publications | 3.1 | 3.1 | 1.8 | 1.8 |
| 2. Participate in education and mentoring of residents, students and care extenders | 2.7 | 2.7 | 2.2 | 2.4 |
| 3. Conduct or participate in research, clinical trials, outcome studies and product development | 2.3 | 2.3 | 1.2 | 1.4 |
| 4. 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) | 2.2 | 2.3 | 0.8 | 1.1 |
| 5. Volunteer to support the profession (e.g., professional organizations, committees licensure boards, community-based programs, international outreach) | 2.5 | 2.4 | 1.1 | 1.3 |
| 6. Promote the awareness, competency and enhancement of the orthotic/prosthetic profession | 2.9 | 2.9 | 1.9 | 1.9 |
Frequency: 0=Never or N/A, 1=Quarterly or less, 2=Monthly, 3=Weekly, 4=Daily
Importance: 0=Of no importance, 1=Of little importance, 2=Of moderate importance, 3=Important, 4=Very Important
