Defining Change

Acquiring extra change ($$$) for delivering change in function should be simple.  A patient will improve, not improve or worsen.  Sounds simple enough.  Is it though?

Of course, some type of measure should be utilized at baseline and then again later at various time intervals throughout the episode of care.  Obviously, to interpret the difference in scores, statistics are required to define relevant change.

Various populations may have different figures for relevant change for the same measure.  Take, for example, the Berg Balance Scale.  If I interpret what I read correctly, knowing the amount of relevant change to determine outcome will be tedious.  For the Berg Balance Scale, apparently a 2 point change for someone with Parkinson's disease is relevant; a 5 point change for older patients with or without a cerebral vascular accident is relevant; a 3 point change for patients with hemiparesis is relevant; a 4 point change for patients with traumatic brain injury is relevant.

The idea of acquiring extra change for delivering change in function is going to cost us our time and our money spent on technology to assist us in the process.  Will our efforts gain us more than just a pile of change?

Selena Horner

- photo by Flickr renewleeds