Analysis of Pinellas Park

Prosthetics (3P) Patient

Education

Team D: Tim Fair and Jillian Gifford

EME620 Systematic Instructional Design
Assignment: Problem Statement
February 10, 2016

The Organization
Pinellas Park Prosthetics, also known as 3P, is a small private healthcare practice
specializing in amputee and prosthetic care. The practice consists of three
prosthetists who see and treat patients, one of which is the owner and office
manager. In addition, 3P has a support staff consisting of two front office assistants
and one fabrication technician.
This practice has an average patient load of 18 patients per day which totals
approximately two million dollars in annual gross revenue. Prosthetic care falls into
the healthcare reimbursement category of Durable Medical Equipment, Orthotics
and Prosthetics or DMEOPS. Unlike other types of health services which charge
for office visits and time spent with the patient, this category of care may only
charge a fee at the final delivery of a prosthetic device. All other office visits and
time spent with the patients are done free of charge, or rather, included in the
final delivery cost.
Problem Statement
Current changes in both the Center for Medicare and Medicaid Services as well as
private insurance has put a large push on healthcare providers to reduce costs,
reduce medical errors, become more efficient, and increase patient outcomes. In an
effort to achieve this, a highly focused on area of improvement nationally has been
in the arena of patient education.
Pinellas Park Prosthetics current patient education practices include formal training
on patient education given while the prosthetists are training at university. For
some of 3Ps prosthetists, this was more than 20 years ago. 3P also institutes
semiannual training mandated by the Florida Department of Health on patient
safety, documentation, compliance, and disease prevention. Outside of this formal
training, there is no company policy regarding how to deliver patient education.
In addition to the pressures from the changing face of healthcare, the owner and
manager of Pinellas Park Prosthetics has noticed repeated high numbers of
scheduled and walk-in follow-up patient appointments made that result in reeducation of the patient, specifically in regards to the education of daily adjustment
of prosthetic fit through the use of prosthetic socks.
These factors clearly display a felt need surrounding Pinellas Park Prosthetics
patient education practices. Current prosthetic socket management education
strategies are not effective across all patients treated at this clinic.
The consequences of continuing with current prosthetic sock patient education
practices include:

poor patient satisfaction

increased potential for medical errors and sentinel events
increased probability of lawsuit
decreased satisfaction of referral sources
decreased community perception

loss of revenue due to time loss

Aim
In an effort to solve this problem, creation of effective prosthetic socket fit
education will be required.
Target Audience, Learners, and Learner Analysis
The target audience of this instructional solution are the practitioners of the Pinellas
Park Prosthetics practice. The patient education will be designed to be administered
through the prosthetists. The target learners of this instructional solution are the
prosthetic patients of Pinellas Park Prosthetics. Please see the following diagram for
a visual of the learner analysis.

Goals
Based on the target learners, this instructional solution will include the following
goals:
1.
2.
3.
4.
5.
6.

Identify when the prosthetic socket is fitting poorly

Identify how to improve the socket fit
Understand what resources are available to improve the socket fit
Reduce skin issues due to poor socket fit
Increase the patients satisfaction with their prosthetic socket fit
Reduce time loss due to education related follow up visits

Strategy
To ensure effective patient education is designed, background analysis of current
patient knowledge and feelings surrounding prosthetic sock fitting will be done.
Short 15 question questionnaires will be administered in office by the front office
staff to patients before prosthetic appointments (Appendix A). Concurrently,
interviews with each practitioner (Appendix B) and 10-15 randomly selected
patients will be conducted to get a deeper sense of current practices and future
needs. Questionnaires and interviews will be administered over a two week period.
An additional week will be required for follow up and analysis.
Sample Size
The sample size will include 110-150 patient questionnaires, 10-15 patient
interviews, and interviews of all three practitioners.
Expected Analysis
Analysis of the returned questionnaires and interviews will take approximately one
week to complete. Simple mixed methods statistics will be employed and
documented using Excel.
Expected Results
The expected analysis of the patient population will reveal that there lies a gap in
prosthetic socket fit patient education. A moderate to large portion of the patient
population is expected to state that they have had prosthetic skin issues secondary
to poor prosthetic socket fit. A moderate to large portion of the patient population
is expected to state that they did not have or did not use prosthetic socket
management resources properly.

Action Plan & Deliverables

Based upon the expected results, the following action plan will be implemented:
1. Create a policy for Pinellas Park Prosthetics patient education to be followed
by the prosthetists
a. Expected time: 2 weeks
2. Create instruction to be distributed by the prosthetists to the patients
a. Printable Pamphlet
i. English
ii. Spanish
b. Web-based Interactive Video Module
i. English
ii. Spanish
c. Expected time: 6 weeks
3. Create documentation for prosthetists to track patient education and
outcomes
a. Expected time: 2 weeks

Expected Completion
May 2, 2016

Appendix A Patient Questionnaire

1. How long have you been an amputee?
a. Under 6 months
b. 6 months to 2 years
c. More than 2 years
2.
3.
4.
5.

How does your socket fit in the morning?

How does your socket fit at night?
How do you manage your socket fit during the day?
Have you had any blisters, callouses, or pressures sores on your residual

limb?
6. Do you use socks? If so, how often?
7. Are the socks different thicknesses? (i.e. 1ply, 3 ply, 5 ply)
8. Do you use shrinkers? If so, when?
9. Were you taught how to manage socket fit?
10.Who taught you about managing socket fit? Please check all that apply.
a. Prosthetist
b. Another amputee
c. Self-taught
d. Other _____________
11.How were you taught about managing socket fit?
12.Are you satisfied with your level of knowledge regarding managing socket fit?
13.Could you teach another new amputee how to manage their socket fit?
14.Do you have any additional comments of questions?
15.Would you like to be contacted regarding this questionnaire?

Appendix B

[Save place for sample practitioner interview]