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Table 1 Performance objectives for physical therapist and practice quality managers

From: Development of a theory- and evidence-based intervention to enhance implementation of physical therapy guidelines for the management of low back pain

Individual physical therapist
Overall guideline adherence 1. See the guideline as a valuable quality tool
2. Decide to make an effort to improve their adherence to the guidelines
3. Keep patient records that contain sufficient information to enable reflection on the quality of their work
Self regulation and goal setting Set goals and make plans, using self-monitoring, self-judgement, self-reaction, self-evaluation and maintenance of procedure
4a. Improve work quality by means of self-regulation
4b. Regularly reflect on work content (self monitoring)
4c. Judge personal performance
4d. React on the basis of judgement
4e. Evaluate the effect of actions
4f. Maintain this procedure
Clinical reasoning diagnostics 5a. Correctly and completely assess the patients’ complaints in all the subsets of the ICF
5b. Categorize the patient correctly on the basis of episode duration, course and the presence of psychosocial variables (choose the correct patient profile)
5c. Choose adequate examination objectives and examination strategies
Clinical reasoning questionnaires 5d. Apply questionnaires
Clinical resoning treatment plan 6a. Choose applicable treatment objectives and treatment strategies
6b. Apply a hands off approach in the case of acute LBP with a normal course
6c. Apply a limited number (maximum 4) of treatment sessions in case of acute LBP with a normal course
6d. Provide adequate advice to the patient
6e. Formulate sound arguments when they diverge from the guideline recommendations
Psychosocial (ps) factors 7a. Assess psychosocial factors
7b. Integrate factors in the treatment-plan and decide about how to deal with these factors
7c. Address factors in the treatment of the patient with low back pain
Practice quality manager
Quality management 1. Decide to start a quality improvement project
2. Plan and make preparations for a quality improvement project
2.1 Provide the necessary materials and means for optimal quality of care
2.2 Involve experts, if applicable
2.3 Develop or maintain a practice culture of openness and mutual respect
3. Manage the quality improvement project
3.1 Bring the available materials to the attention of colleagues
3.2 Guard the open practice culture
3.3 Bring the possibility of cooperation with other disciplines to the attention of colleagues
3.4 Support colleagues in their deliberation/cooperation with other relevant disciplines
3.4 Assure the possibility for retraining
4. Evaluate the quality improvement project
5. Ensure care of continuation