Chapter 3: Clinical Decision-Making for Massage Outcome-Based Massage: From Evidence to Practice.

Chapter 3: Clinical Decision-Making for Massage

Chapter 3: Clinical Decision-Making for Massage

Outcome-Based Massage: From Evidence to Practice

Outcome-Based Massage: From Evidence to Practice © 2009 LWW

ObjectivesObjectives

At the end of this presentation, you will have the information needed to:

• Describe the 4 phases of the clinical decision-making process

• Describe how to formulate and select tests and measures for examination

• List the steps in synthesizing clinical findings and creating a clinical problem list

• List impairments clinicians can treat with massage techniques and the related outcomes


Objectives (cont.)Objectives (cont.)

At the end of this presentation, you will have the information needed to:

• Formulate outcomes that are relevant to the use of massage techniques

• Outline how to select massage techniques

• Identify how to use findings from the re-examinations to modify, refine, and progress interventions

• Describe how to identify the client’s discharge needs, plan for discharge, and discharge a client


Clinical Decision-MakingClinical Decision-Making

• The process by which therapists analyze client information and formulate and progress therapeutic regimens for their clients


The Clinical Decision-Making ProcessThe Clinical Decision-Making Process

• Not intended to be used in a linear, sequential manner

• Therapists using clinical decision-making perform several steps of the process concurrently.

• They also cycle through the same steps of the decision-making process several times.

• Each time they repeat the steps, they expand on their information and refine their hypotheses.


Phases in Clinical Decision-MakingPhases in Clinical Decision-Making

• Evaluative Phase

• Treatment Planning Phase

• Treatment Phase

• Discharge Phase


The Evaluative PhaseThe Evaluative Phase

• Provides the foundation of the clinical treatment process

• The steps revolve around formulating and confirming a clinical hypothesis about the client’s clinical problem or wellness goals.

• Begins with data gathering through the client examination

• Involves confirming the clinical problem or wellness goals, creating summary of clinical findings, and deciding to treat


The Treatment Planning PhaseThe Treatment Planning Phase

• Identifying body structures and functions that are appropriate for treatment

• Selecting treatment techniques to improve the client’s impairments in body structures and functions, functional limitations, or overall wellness

• Begins with the summary of clinical findings from the Evaluative Phase

• Ends with a written plan of care


The Treatment PhaseThe Treatment Phase

• An ongoing cycle of treatment, re-examination, and treatment progression

• Begins after the therapist completes the plan of care

• The end of this phase is not clearly delineated.

• There is a gradual transition from Treatment Phase to Discharge Phase.


The Discharge PhaseThe Discharge Phase

• Discharge: the transition of the client from the therapist’s care to self-care or to treatment by another therapist

• Begins before the client’s discharge date

• Spans the period from the initiation of discharge planning to the actual discharge date


The Evaluative PhaseThe Evaluative Phase


Steps in the Evaluative PhaseSteps in the Evaluative Phase

• 1: Conduct Subjective Examination

• 2: Generate Preliminary Clinical Hypothesis

• 3: Conduct Objective Examination

• 4: Confirm the Clinical Hypothesis

• 5: Summarize Pertinent Clinical Findings

• 6: Determine Appropriateness for Treatment


The Treatment Planning PhaseThe Treatment Planning Phase


Steps in the Treatment Planning PhaseSteps in the Treatment Planning Phase

• 7: Analyze Findings and Generate the Clinical Problem List

• 8: Identify Functional Outcomes

• 9a: Identify Treatable Impairments and Relevant Outcomes

• 9b: Plan Compensatory Strategies


Steps in the Treatment Planning Phase (cont.)Steps in the Treatment Planning Phase (cont.)

• 9c: Identify Impairments Appropriate for Massage Techniques

• 10 a,b: Select Treatment Techniques

• 11: Generate the Plan of Care


The Treatment PhaseThe Treatment Phase


Steps in the Treatment PhaseSteps in the Treatment Phase

• 12 a,b: Select Treatment and Re-Examination Techniques

• 13: Carry Out Initial Intervention

• 14: Conduct Client Re-Examination

• 15: Assess Client Progress

• 16 a-d: Address Lack of Change


The Discharge PhaseThe Discharge Phase


Steps in the Discharge PhaseSteps in the Discharge Phase

• 19: Identify Post-Discharge Needs

• 20, 21: Initiate Post-Discharge Education and Referrals

• 22, 23: Progress Plan of Care and Determine Readiness for Discharge


Steps in the Discharge Phase (cont.)Steps in the Discharge Phase (cont.)

• 24, 25: Finalize Discharge Plans and Review Home Program

• 26, 27: Conduct Discharge Examination and Discharge Client


ReferencesReferences

• The references for the material in this PowerPoint presentation are found in Chapter 3: Clinical Decision-Making for Massage.

Chapter 3: Clinical Decision-Making for Massage Outcome-Based Massage: From Evidence to Practice.

Documents

Transcript of Chapter 3: Clinical Decision-Making for Massage Outcome-Based Massage: From Evidence to Practice.