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A Resident-Managed Quality Improvement Project Tracking Spine Conditions Using Functional Outcome Measures to Track Episodes of Cares for Merit Incentive Payment System Requirements (MIPS)

Marc P. Gruner, DO, MBA, RMSK (Medstar Health/Georgetown-National Rehabilitation Hospital PM&R Program, Washington, DC, United States); John Taylor Mansfied, DO; Nolan Gall, MD; Matthew Maxwell, MD, CAQSM, FAAPMR

Meeting: AAPM&R Annual Assembly 2019

Session Information

Date: Saturday, November 16, 2019

Session Title: Quality Improvement Case and Research Report

Session Time: 11:15am-12:45pm

Location: Research Hub - Kiosk 8

Disclosures: Marc P. Gruner, DO, MBA, RMSK: Nothing to disclose

Case Description: The goal of our quality improvement project is to implement a resident-managed program tracking functional outcome measurements in musculoskeletal outpatients. Using a validated measure, we collected self-reported data regarding functional improvement in activities of daily living (ADL’s). Each outcome measure computed a quantitative number to measure the patient’s baseline overall function for various body parts. We report this as a method for residents in the clinic to improve patient quality of care using management of therapy, injections, and medical management of patients care.

Setting: Academic Medical Center Physiatry Sport and Spine Center

Patient 234 patients

Assessment/Results : We collected over 30 variables for resident inquiry in relationship to ODI which includes demographic data, PT orders, imaging orders, medications, and length of back pain.

Discussion: The entire implementation of outcome measures on to our electronic health record system, changing our intake form, integrating a standardized workflow operation, and teaching staff took over 2 years. This is the first to our knowledge of a resident management quality improvement project to connect outcome measures to our EHR system and run reports for us to examine all aspects of patient’s information in relationship to functional outcome measures. Having the ability to track this functional outcome measure in clinic is one of our strategies for measuring quality and performing a quality improvement activity for MIPS requirements. This study is a first step to establishing episodes of care for physiatry patients.

Conclusion: As physiatrists are exploring different value based models for episodes of care of spine care, this project is an example of how residents can contribute to researching and studying an episode of care for low back pain. Our quality project examined m-ODI functional outcome measure to other variables to get a better understanding of how our clinicians could provide high quality-cost effective care.

Level of Evidence: Level V

To cite this abstract in AMA style:

Gruner MP, Mansfied JT, Gall N, Maxwell M. A Resident-Managed Quality Improvement Project Tracking Spine Conditions Using Functional Outcome Measures to Track Episodes of Cares for Merit Incentive Payment System Requirements (MIPS) [abstract]. PM R. 2019; 11(S2)(suppl 2). https://pmrjabstracts.org/abstract/a-resident-managed-quality-improvement-project-tracking-spine-conditions-using-functional-outcome-measures-to-track-episodes-of-cares-for-merit-incentive-payment-system-requirements-mips/. Accessed May 12, 2025.
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