This final post in the series merges my clinical thinking cap with the science presented in the Intake Functional Status Summary. The final question I pose after reviewing the summary is if the prediction seems reasonable for the patient sitting in front of me.
A bit of additional information is required for me to determine if I agree with the FOTO prediction.
Don't get me wrong, I truly appreciate having an estimate on the number of visits... the duration of time... and the final functional status for patients right at my fingertips at a glance. It's just that the Intake Functional Status Summary doesn't take into account the whole patient story. I enjoy hearing the patient's story. I like to know if the person in front of me believes their situation is improving. I like to know if the person believes it will improve. I like to take into consideration the person's previous activity level. If the person was injured at work, I learn about the person's work relationships. My examination and evaluation have a component of differential diagnosis to ensure the person sitting in front of me fits the FOTO impairment category AND has a condition that will respond to physical therapy services. (My processes include emailing the Intake prior to the initial visit.) I also attempt to get a feel for how invested the person is with regard to actively addressing his/her current situation. Will the person take time to perform recommended activities consistently (i.e. home exercise programs)?
So, then what do I do? I combine my clinical expertise and thinking with the Intake Functional Status Summary information. I use all the information available to me to drive my communication style, determine interventions and set individualized goals. And then, I have to create buy-in with the patient. Craig Johnson kindly summarizes this in his comment in Part III, "So the duty of the therapist is to understand all the data, and explain the final outcome in terms the patient can understand. That level of engagement by the therapist needs to be the norm. Engaging the patient in their own improvement using data and staging will increase the likelihood of a successful patient outcome and a capture of that success in FOTO."
Hope you enjoyed the series on how the Intake Functional Status Summary can be clinically incorporated into your examination and evaluation process.
Until next time,