An Exploratory Qualitative Study of Health Professional Perspectives on Clinical Outcomes in UK Orthotic Practice

Abstract Background: Despite potential savings to the National Health Service, the collection of data on outcomes of NHS orthotic services is patchy. Indeed, several reports into orthotic services in the UK have reported a lack of data relating to outcomes of care and highlighted the need to routinely record outcomes to demonstrate efficacy of services. This research aimed to explore orthotic service professional perspectives on outcomes in orthotic practice. A secondary aim was to explore potential barriers to the routine use of outcome measure tools in practice.Methods: Following a review of the literature, an initial advisory group involving experts in the field was conducted. From this, semi-structured questions were developed, and a focus group was undertaken. Data from the focus group was transcribed and analysed using thematic analysis, creating themes and subthemes for discussion.Results: The participants considered a successful outcome as a ‘usable’ orthosis, this linked to a preference for evaluation of patient reported outcomes. The setting of realistic joint goals via patient education was seen as a method of improving outcomes. Barriers to collection of data were associated with inadequate technology to manage the ‘data burden’, lack of clinical time to complete and difficulties selecting outcome measure tools for a varied population. Issues around usability of current outcome measure tools were also highlighted. Participants discussed ways of addressing these barriers, such as the use of ‘snapshots’ and delegation of data collection. Conclusions:This research is unique in that it is the first-time orthotic service professional opinions have been analysed specifically relating to outcomes, outcome measure tools and possible barriers to their use. The participants acknowledged the relevance of outcome measure tools, identified barriers to use but had created novel ways to address barriers. Further, they indicated that to achieve good outcomes it was important to address service user expectations of treatment, discuss and establish joint goals for care at the outset and communicate/ educate on the clinical reasoning process. This research has contributed to current knowledge within the field of orthotics and may provide a theoretical basis for future research in the field.