Evidence Based Practice: How Are You Measuring Outcomes; PART 3

SPEAKER BLOG SERIES:

Suzanne Davis

Suzanne Davis

GAS is similar to SMART (Subjective, Measurable, Achievable, Realistic/Relevant, and Timed) goals in that they both require repeatable, observable, specific conditions under which outcomes can be measured.  However, GAS is unique in that there are at least 5 levels of outcome.  The chart below demonstrates this concept:
 GAS Key  -2= much less than expected outcome -1= somewhat less than expected outcome 0= expected level of outcome, most probable outcome from treatment +1= somewhat more than expected outcome  +2= much more than expected outcome 
As noted in the chart the “0” level is the expected outcome or level of attainment following intervention.  Then there are two more favorable outcomes that graduate to higher achievement than expected, and two less favorable outcomes that are lower than expected.  Using this scale a therapist can determine if a child has made some progress toward the goal even if the child did not fully achieve the expected outcome, and also whether or not the child has exceeded expectations and achieved a higher outcome than expected. Using GAS scaling in combination with the International Classification of Function (ICF) model developed by the World Health Organization lends further credence to this tool.  Goals can be written with components that address the various domains of the ICF model (participation, activity, impairment, etc.)  GAS can also be used in family-centered practice and lends itself to collaborative goal writing and intervention. The next blog will give more criteria to GAS goals and provide examples of GAS and SMART goals as applied to the same function.]]>

Education Resources Competition – Win a Free Course

NEW

NAME THAT COURSE!

Coming later this year –  a course with a new unique approach. We are excited to announce a new lab intensive acute care course offered by internationally respected Cardiovascular and Pulmonary Clinical Specialist Komal Deokule, PT, MSc.PT, CCS, MCSP, MPNZ, MIAP We would appreciate our community’s input when it comes to developing the title. This course has a focus on respiratory complications co-morbid with acute illness.  It is lab intensive focusing on approaches to safe reconditioning.  What title will best describe this course? Please send us your thoughts by May 23rd, and we will enter your name into a random drawing to be selected to receive a free spot to a course of your choosing. Post your thoughts in the comments below or email me: mwashington@educationresourcesinc.com  ]]>

New Study: Helmets Do Little to Help Moderate Infant Skull Flattening

The New York Times  published the news with links to the BMJ report and to an accompanying editorial by Brent R Collett an investigator at Seattle Children’s Research Institute As therapists, what are your thoughts to this research? Please share any of your experiences.]]>

Physician Screening Tool, PT Referral for Low Back Pain May Be Effective Approach for Treatment

We would like to share this article from PT Products

Published on April 4, 2014 by “PT PRODUCTS”

“An editorial in The Annals of Family Medicine suggests that the British screening approach for physicians with patients with low back pain (LBP) may help in creating a US-based approach that more often involves physical therapists (PTs) early on and lowers the financial costs of the condition. In the editorial, authors Timothy S. Carey, MD, MPH, and Janet Freburger, PT, PhD, comment on a new study of physical therapy management of patients with LBP, saying the results are an important step in validating an approach that involves early physical therapy.

According to a news release from the American Physical Therapy Association (APTA), the approach described in the study involves physician use of a British screening tool known as the STarT, which is designed to help a physician assess LBP. Once the assessment is made, a medium- or high-risk patient can be referred to a PT for effective treatment.  The editorial answers the question as to whether or not this approach should be used in the US, with the authors saying yes.

The editorial authors point to logistical and regulatory wrinkles that would need to be worked out, but do note that similar screening approaches, such as those used for depression or alcohol use, were implemented fairly simply. The editorial states, “These advances don’t solve our problems with the large disability burden and high cost of low back pain, but they represent a promising start.”

[Sources: APTA, The Annals of Family Medicine]

]]>

Evidence Based Practice: How Are You Measuring Outcomes; PART 2

SPEAKER BLOG SERIES:

[caption id="attachment_1847" align="alignleft" width="160" caption="Suzanne Davis"]Suzanne Davis[/caption]

Suzanne Davis

Considering the three components of EBP, therapy has been particularly lacking in the area of research.  Conducting high-level research is difficult for many reasons.  One of the issues is finding outcome measures that are sensitive enough to measure the changes that the children with neuromotor and sensory dysfunction make. 

A format that is sensitive to individual change is coming to the forefront.  Goal Attainment Scaling (GAS) has been found to be responsive to this need and is now being recommended for use in clinical practice and in treatment outcomes research (Palisano, 1993; Steenbeck, et al, 2005; Ekstrom, et al, 2005).  GAS is an individualized criterion-referenced measure that has been applied in a number of settings.  Because goals are criterion-referenced versus norm-referenced it is a tool that is responsive to small but clinically significant change (McDougall & King, 2007).  It can be used to determine the effectiveness of interventions with individuals as well as programs. 

In the next entry of this blog, I will provide details on the GAS as well as compare and contrast GAS to SMART goals. 

What tools are you using to show measurable change in the children’s outcomes?  Share them here.

]]>