Incorporating injured employee outcomes into physical and occupational therapists' practice: a controlled trial of the Worker-Based Outcomes Assessment System.
BACKGROUND
Work related musculoskeletal disorders (WRMSDs) remain costly. The Worker-Based Outcomes Assessment System (WBOAS) is an injury treatment improvement tool. Its purpose is to increase treatment effectiveness and decrease the cost of care delivered in Occupational Health Service clinics.


METHODS
The study used a non-randomized (parallel cohort) control trial design to test the effects on injured employee outcomes of augmenting the standard care delivered by physical and occupational therapists (PT/OTs) with the WBOAS. The WBOAS works by putting patient-reported functional health status, pain symptom, and work role performance outcomes data into the hands of PT/OTs and their patients. Test clinic therapists were trained to incorporate WBOAS trends data into standard practice. Control clinic therapists delivered standard care alone.


RESULTS
WBOAS-augmented PT/OT care did improve (p< or =.05) physical functioning and new injury/re-injury avoidance and, on these same dimensions, cost-adjusted outcome. It did not improve (p>.05) mental health or pain symptoms or return-to-work or stay-at-work success nor, on these same dimensions, cost-adjusted outcome.


CONCLUSIONS
Training PT/OTs to incorporate patient-reported health status, pain symptom, and work role performance outcomes trends data into standard practice does appear to improve treatment effectiveness and cost on some (e.g. physical functioning) but not other (e.g. mental health, pain symptoms) outcomes.
Ross
Robert H
RH
Department of Medical Laboratory and Radiation Sciences, College of Nursing and Health Sciences, University of Vermont, 302 Rowell Building, 106 Carrigan Drive, Burlington, VT 05405, USA. rhross@uvm.edu
Callas
Peter W
PW
Sargent
Jesse Q
JQ
Amick
Benjamin C
BC
Rooney
Ted
T
D000328:Adult; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000191:economics / Q000534:rehabilitation*; D009784:Occupational Diseases / Q000191:economics / Q000534:rehabilitation*; D009788:Occupational Therapy / Q000191:economics / Q000379:methods*; D010043:Outcome and Process Assessment, Health Care / Q000191:economics; D010147:Pain Measurement; D026741:Physical Therapy Modalities / Q000191:economics; D018582:Sick Leave; D014707:Vermont