Research Emphasizes Benefits of Patient Education

Nov 11, 2015 | Insights

Knowledge is power – a point especially true for injured workers undergoing rehabilitation. Feeling comfortable and in control—or not—has a significant impact on treatment outcomes.

Two recent studies found a positive relationship between education and patient results—validating the importance of patient education in driving positive outcomes, efficient return to work and overall cost savings. However, understanding what effective patient education looks like and actually implementing it aren’t as widely reflected in industry policies and procedures as they could and should be.

Reducing Outliers, Speeding Recovery, Lowering Costs

Last year, Ohio researchers reported on the positive effects the educational aspect of preoperative physical therapy had on knee and hip replacement outcomes.[i] This year, Gallup researchers saw a similar trend when they looked at how pre-surgery education affected post-surgery results as measured by patient satisfaction, problem incidence and quality of life.[ii]

When you look at the actual numbers, it is clear that patient education can have far-reaching effects on patients’ lives and on carriers and carrier personnel burdened with delayed recovery cases and ever-increasing costs.

The Ohio researchers found just one to two physical therapy sessions in advance of surgery resulted in an estimated 29% reduction in postoperative care.[iii] Contrary to assumptions, it wasn’t so much the physical strengthening or range of motion benefits that drove the change, as that would have required multiple intensive sessions. Rather, the origin of the improvements was the fact that patients were receiving quality and knowledgeable instruction on what to expect from the procedure and recovery process in advance, improving patient satisfaction overall.

According to the Gallup research, patients that felt they were well educated in advance of their procedures—knew what to expect, were prepared for and followed post-procedure instructions—were 33 percent more satisfied with the results, experienced 19 percent fewer problems and reported a much higher level of contentment[iv]. They also had fewer readmissions indicating faster, smoother recoveries, and a potentially lower overall cost-per-patient.

What Does Effective Patient Education Look Like?

“Quality” patient education is a vague target—too subjective to drive real change. So what exactly does an effective patient education program look like?

Researchers posit that managing patients’ expectations in advance is key to improving their level of satisfaction with the results of their procedures, as well as the physical and emotional outcomes. A positive educational experience can even have beneficial effects beyond the procedures themselves, increasing patients’ feeling of personal well-being.[v] For delayed recovery cases, where the psychosocial and emotional barriers can be just as important to address as the physical, patient education has the potential to speed long-stalled recoveries.

At MedRisk, we’ve seen this research born out again and again. Patient education is of paramount importance to improving outcomes, and that’s why we believe that a patient-centric approach is a critical component of a successful managed care program. It not only improves the quality of patient care – it encourages compliance with treatment strategies, reduces the workload for busy adjusters and case managers and helps remove psycho social barriers to recovery. It’s why our managed physical medicine program includes one-on-one concierge service and patient education in advance of treatment.

The healthcare industry in general, however, has not yet realized much less adopted this revolutionary method to sustaining improved outcomes. For example, only 37% of respondents in the Gallup study felt they received enough information on the important aspects of upcoming procedures.

How can MedRisk help? By providing a comprehensive and managed approach to repair and rehabilitation involving clinical oversight, tailored communication, a superior educational component, integrated services and a continuum of care that ensures patients feel confident, comfortable and empowered.

The more the medical and insurance communities can incorporate higher levels of communication and education into their engagements with patients, the better the outcomes will be for not only the patients themselves, but the industry as a whole.

[i] http://www.apta.org/PTinMotion/News/2014/10/2/PreOperativePT/

[ii] http://www.gallup.com/businessjournal/183317/benefits-pre-surgery-education.aspx

[iii] http://www.apta.org/PTinMotion/News/2014/10/2/PreOperativePT/

[iv] http://www.gallup.com/businessjournal/183317/benefits-pre-surgery-education.aspx

[v] http://www.gallup.com/businessjournal/183317/benefits-pre-surgery-education.aspx

Statistics Spotlight: Physical Therapy Reduces Costs

Nov 11, 2015 | Insights

For patients with a new episode of lower back pain, studies show a clinical pathway that begins with physical therapy rather than MRI reduces first-year treatment costs by 72%.

According to a study published in the journal Health Services Research, initial treatment costs for patients with low back pain were 50% lower when the primary care consultation was followed by a physical therapy referral rather than an advanced imaging referral. In fact, over time, using physical therapy as a first management strategy actually resulted in 72% fewer costs within the first year.

The patients who received physical therapy first were less likely to receive surgery and injections, and they made fewer specialists and emergency department visits within a year of primary consultation.

The authors suggest that advanced imaging may heighten patient and provider concern leading to a push for additional care, whereas physical therapy empowers patients to actively self-manage their condition.

Fritz JM, Brennan GP, Hunger SJ. Physical Therapy or Advanced Imaging as First Management Strategy Following a New Consultation for Low Back Pain in Primary Care: Associations with Future Health Care Utilization and Charges. Health Serv Res. 2015 Mar 16. doi: 10.1111/1475-6773.12301.

Getting Injured Workers Back on the Job: The Employer’s Role

Jul 28, 2015 | Insights

When it comes to getting an injured worker back on the job, employers bear a not-insignificant part of the responsibility. While the employer is not the one doing the recovery, he or she does set the tone for an efficient return to work – and the employee’s long-term well-being.

What does that look like in the real world? Here are five things employers can do to help get injured workers back on the job quickly and effectively.

Communicate Expectations Clearly

The first step in any successful transition back to work is clear expectation-setting on the part of the employer. The vast majority of injured employees are going through the process for the first (and only) time; they won’t necessarily know what’s expected of them, or how to facilitate a return to the job. By keeping lines of communication open, providing actionable resources and providing realistic milestones, employers can keep workers confident, optimistic and engaged in their recovery.

Implement Evolving Corporate Guidelines

There is no “one-size-fits-all” solution to on-the-job injuries, but many factors can be addressed by universal corporate guidelines. Having a good set in place increases administrative efficiency, makes it easier to answer employee questions and significantly reduces legal risk. In addition, making plans to regularly update these guidelines based on what’s working allows all injured workers to benefit from best practices developed over time.

Help Ensure an Accurate Diagnosis

An accurate diagnosis is fundamental to effective treatment and speedy return to work. Employers can help ensure this happens by working with managed care organizations with networks of highly qualified, thoroughly vetted diagnostic imaging providers. The better the quality of network providers, the better the diagnosis.

Insist on Work Hardening/Conditioning

A work hardening/conditioning program is an essential “last step” in the treatment process. Intensive and highly focused, it builds on the foundation built in physical therapy or occupational therapy by adding job-specific tasks and skills. After the completion of work hardening/conditioning, a worker won’t just be “well” – he or she will be job-ready.

Don’t Ignore Psychosocial Factors

Research shows that psychosocial factors – catastrophizing, fear, disability beliefs, perceived injustice, etc. – account for as much as 30 percent of disability magnitude variance, compared to just 10 percent for pain. Simply put, this means that physical recovery is far from the only factor that plays into an injured employee returning to work; overcoming mental barriers is just as important – if not moreso. Fortunately, top managed care organizations have started addressing psychosocial factors through programs. Designed to promote reintegration into life-role activities, increase quality of life and facilitate return to the job, these solutions provide cost-effective ways to reduce the number of long-term workers’ comp cases.

Click here to learn more about work hardening or work conditioning preparation.