A national survey to explore clinical data and outcome measure collection, storage, and use, within prosthetic rehabilitation services during implementation of the National Health Service England microprocessor controlled prosthetic knee clinical commissioning policy.

Abstract

Routine health care data remain underused for enhancing care quality, safety, and cost-effectiveness, and for research. Little is known about data collection and outcome measurement (OM) in English prosthetic services. This insight could inform health care quality improvement and future nationwide data initiatives. To examine data collection and OM practice undertaken during implementation of the Microprocessor Controlled Prosthetic Knee Clinical Commissioning policy in English prosthetic services. Nationwide survey of practice. An online survey was developed and piloted with clinicians working in English prosthetic rehabilitation centers. The survey was deployed to all 35 of England's prosthetic services. Centers were asked to complete one survey per center. Twenty-two centers completed the survey. Twenty of 21 patient data items were collected at rates >80%, whereas 5 of the 6 core outcomes were captured at rates exceeding 90%. Variation was observed in the scoring and administration methods of OMs across centers, limiting comparison of scores. Clinically, patient outcome data were most often used to inform individual decision making regarding microprocessor knee prescription (95%). However, 50% of centers suggested OMs needed to be more useful and relevant. Forty-one percent of centers do not collate data across patients. The consistency of types of data captured demonstrate the importance of this data for implementation of the National Health Service England microprocessor knee policy. This work has identified several areas of variability, such as OM administration and collation of data, that present operational and educational challenges for the clinical use of routine health care data and OMs. These challenges need to be considered for those implementing future service provision policies or aiming to develop a national prosthetic data collection initiative.