Knowledge translation of health outcome measurement research into clinical practice to improve health care effectiveness and efficiency in a Prevention and Early ACtive Return-to-work Safely (PEARS) …

With population growth, an aging population, and an aging and supply-limited workforce of health professionals, British Columbia is challenged to sustain its current levels of health services in the face of unprecedented demand. In this context, the use of valid health outcome measures (OMs) is important to evaluate and improve the results of various interventions for health professionals with musculoskeletal injury (MSI)-related disabilities. Prevention and Early Active Return-to-work Safely (PEARS) is a primary (injury prevention) and secondary (physiotherapy for MSIs) program designed to reduce disability in healthcare workers who have sustained a workplace injury. Outcome measures used in the program pilot included Activity-level self-report disability questionnaires. With expansion of PEARS across BC, only Participation-level outcomes like time-loss duration and level of return-to-work were retained. Currently, few physiotherapists in PEARS are using disability measures, limiting ability to measure effectiveness of the secondary prevention component of the program. This further limits ability to improve outcomes through predictive modeling and examining effectiveness of the variety of available treatments. Allan Kozlowski is evaluating a training program intended to promote the adoption of self-report outcome measures by PEARS program physiotherapists. In addition to information about how to use the OMs, individual- and organizational-level barriers will be identified and addressed. The objective is to demonstrate that physiotherapists can measure disability outcomes as part of their practice without diminishing patient service. Implications of this work include enhanced decision-making for individual patients, identifying ‘best-practice’ treatments, managing distribution of resources within health authorities, and development of enhanced predictive modeling of outcomes, all of which would contribute to a viable and sustainable health care system.