Vol. 7, No.8

October 2002

Project Quantum Leap Begins

Activities Will Benefit Entire O&P Profession

What began as an impassioned speech about the pressing needs of the O&P profession has blossomed into a full-blown, series of activities over many years. Thomas V. DiBello, CO, FAAOP called it “the most important initiative the Academy has undertaken in its 30-year history" as he was finishing his term as Academy President in 2001. Since then it has become a central priority of the Academy as evidenced by its prominence during the strategic planning discussions this summer.

Project Quantum leap, or PQL as it is most often referred to, is an umbrella term for several activities that will benefit the O&P profession as a whole in three areas: increasing awareness of O&P as a career choice and helping the few O&P schools via government funds, documenting clinical standards of practice, and encouraging applied research in O&P. Each of these areas will have several activities within them.

Larger retirement numbers ahead as Baby Boomers quit

The 2002 updated study on Issues Affecting the Future Demand for Orthotists and Prosthetists by Caroline Nielsen, PhD, summarized the challenge in one sentence in its executive summary. Without substantial changes in the number of educational programs, and the number of graduates becoming certified, the profession will be unable to serve the needs of a substantial percent of the population. Without sufficient numbers of qualified practitioners patients will look to alternate healthcare providers who will not fully understand the nuances of the techniques, materials or technologies available to assure quality care. (Copies of the updated Nielsen study are available from NCOPE for $25.) Several O&P programs report they are seeing fewer applications each year. Strong university based O&P programs not only provide the training for the professionals of the future, but these institutions also lend credibility to the O&P profession. It is imperative more students be exposed to orthotics and prosthetics as a career possibility while they are in high school. In addition, the Academy is working with the O&P university programs to save the existing grants that are threatened and to seek additional, less restricted resources for them. O&P.

The Joint Committee on O&P Awareness, comprised of representatives from the Academy, ABC, AOPA, NCOPE, OPAF, NAAOP, and the Academy’s College Fund, met to solidify plans for increasing the number of students applying to O&P schools. The committee’s ambitious goal is to raise the number of applicants by 10 percent in the next year. Committee Chair Wendy Beattie, CPO, FAAOP, believes it is doable. “We have an imaginative group of professionals that are moving quickly to implement their ideas," Beattie explained. Among the projects under development are: a website with career information about what it is like to be an orthotist prosthetist with additional information on schools and scholarships (www.opcareers.org); a canned slide package for volunteer practitioners to use at local Career Fairs; a color brochure for guidance counselors to use to direct students to the O&P career website; and expanding the number of other websites that also have career information about the profession. Practitioners who wish to deliver a slide presentation at their local high school’s Career Fair should contact the Academy at (703) 836-0788 for the slide package. The Academy is exploring a collaborative working relationship with the American School Counselor’s Association to educate their members about careers in allied health, specifically O&P.

Standards are an essential part of any profession

The second initiative of Project Quantum Leap is the development of clinical standards for the profession. By using the approved medical model of consensus conferences, the Academy will lead the way in developing standards based on scientific data and reviewed by leading professionals in health care, including ABC-certified orthotists and prosthetists. Having a written set of standards is one of the basic elements of any profession. The first consensus conference toward the setting of Clinical Standards of Practice was held in February 2002 at the Texas Scottish Rite Hospital for Children in Dallas and examined Orthotic Treatment of Scoliosis and Scheuermann’s Kyphosis.

The intent of a Clinical Standards of Practice (CSOP) consensus conference is to analyze diagnoses which can be considered difficult to treat or controversial in nature, as well as those where sparse literature is available to guide patient care. “It serves as a mechanism to document our clinical belief systems in what we do and why we do it a particular way," said conference organizer Donald E. Katz, CO, FAAOP, Academy Vice President. Consensus conferences can also tackle some of the biomechanical considerations of how practitioners approach certain challenges with a critical analysis of what is understood to be the outcome of a given approach.

Unlike other symposia where there may be a general registration for a broad number of attendees, a consensus conference is convened with a limited panel of professionals representing a broad range of disciplines and perspectives who meet on an array of clinical issues germane to a specific subject matter. The end goal of a CSOP conference is to publish a document that defines the current status of patient care, to develop consensus on controversial issues where possible, and to identify research priorities.

Katz cautioned those with grand expectations noting that one of the end results of a consensus conference may actually be a question, rather than an answer. “A well-defined question of where more research is needed can play as much a role in improving the quality of O&P care in the future as determining the current standards of care," he explained. The consensus conferences will provide a forum for validation of existing O&P treatments and dispel myths about treatment protocols currently in practice. But most importantly, the conference forum provides orthotists and prosthetists an opportunity to take an active role in the determination of appropriate O&P clinical care.

The Academy has chosen the topic of its second consensus conference to be held in Dallas February 2003. The conference will document the Clinical Standards of Practice (CSOP) for Post-Operative Amputation Care.

Current protocols with regard to the post-operative care of the amputee are significantly lacking. The use of shrinkers, post-operative prostheses and early fitting devices is dictated by region and surgeon. The current research lends little direction to the efficacy and protocol for such devices. Cause of amputation and training of the surgeon and prosthetist seem to have a large impact on the choice of post-operative care the patient receives with little regard for the outcome potential.

Applied research needed

The third area of activity within PQL is the need for applied O&P research. Considerable federal government support has been directed toward basic or theoretical prosthetic and orthotic research. While this is an essential activity, and important technologies have been derived from this research much additional emphasis must be placed on issues involving the determination of what constitutes appropriate care for various orthopedic impairments and neurological conditions. Moreover, a research agenda needs to be developed to focus on those aspects of O&P care where known or determined gaps exist. The Academy will seek to improve patient outcomes by addressing these and other topics through a collaborative, multi-institution research approach.

Plans are being developed to convene a two day Blue Ribbon Conference with its soon to be appointed Research Advisory Panel (RAP) to review the identified gaps in research, including 1) fabrication techniques and materials 2) improper fit and fabrication 3) inappropriate component selection and delivery and 4) consumer satisfaction. The Research Agenda will identify the promising applied research areas for the Academy to fund and assess the need for Post-Graduate level (Master’s, PhD) programs, with the goal to help fuel research in O&P for the future.

A research advisory panel will be created to evaluate research proposals and make recommendations to the Academy Board of Directors on how to disperse the funds. The panel will be comprised of a “broad-based group of expert people" with expertise in research and O&P, says Bostock. “We will encourage individuals or organizations to come forward with worthwhile research projects and submit RFPs," says Bostock. Then the panel will make recommendations to the board about each proposal’s worthiness. Perhaps the most important outcome is that funds will spark activity within the profession. While the possible research topics may be countless, “The money will go quickly," says Bostock. “We need to provide O&P professionals with the resources to help them conduct research," adds Bostock. “That’s one aspect of good quality care."

CEC-2: Phoenix Conference Includes Stance Control

Only a few seats remain for CEC-2 to be held November 15-16 at the Crowne Plaza Hotel in Phoenix. The program offers concurrent sessions worth 12.75 PCE credits and features the debut of the New Practice Management Certificate Program.

Members may choose from sessions focusing on the Stance Control Free Walk KAFO, Cervical Spine Injuries and Halo CTO Intervention, Clinical Gait Analysis, Prosthetic Intervention with Conjoined Twins, Pain Management in Prosthetics, Specialized Orthotics and Prosthetics for Burn Patients, and more. The American Red Cross will offer an Adult CPR Certification Course on Saturday. Participants must attend both sessions to obtain Red Cross certification.

One of the Academy’s most attended certificate programs has been revised and brought back by popular demand. “The Practice Management Certificate Program was an important initial offering and really jump-started the Fellow Program," said Chellie Blondes, Academy deputy executive director. “We had so many requests to bring it back that our president led the task force himself to update and add to the material."

The certificate program includes a selection of eleven modules of which eight must be completed. Several modules now have a short quiz included, which also adds to the number of PCE credits a member can earn. The new certificate program is totally revised and updated with new presenters addressing current issues affecting members’ practices. Scheduled to debut at the Academy’s Annual Meeting in March of 2003, this is a sneak peek at what the program has to offer. Six of the new certificate program modules are being offered at the Phoenix CEC. Attendees will gain knowledge on better ways to create a budget, address concerns regarding the financial management of their company, ensure their company’s policies and procedures cover all the legal bases, learn the basic marketing tools that will help promote and bring new business to their practice, and hear more than a dozen ways to treat employees in a way that promotes loyalty and high productivity.

Scientific Societies Looking for Leaders

The Upper-Limb Prosthetic Society recently completed its election of officers. Randy Alley, CP was elected chair, J. Thomas Andrew, CP, FAAOP as vice chair, and J.W. (Bill) Limehouse, CP, FAAOP as secretary. Elections by mail ballot are now necessary for Lower-Limb Orthotics, Gait, Fabrication Sciences, and CAD/CAM Societies. Nominations within the respective societies have been occurring in the last two months.

Academy Offers HIPAA Compliance Version 2.0

The Academy has updated its comprehensive HIPAA Model Compliance Plans to reflect the recent changes in the privacy rules and added several additional features to benefit members. The Plan, specifically tailored for O&P practitioners, includes all the forms members will need to develop for their practice, an explanation of the Privacy Standards, and detailed policies and procedures to help ensure compliance. In addition, the updated Plan is written using less technical language making it easier to delegate the project to a staff person.

The Plan is available to Academy Members for $300 in CD or notebook form and includes consultation time with Healthcare Compliance Solutions for answers to questions. The Academy has partnered with HCS, an organization that devotes its full efforts to helping practitioners comply with the many healthcare regulations. Members that purchased version 1.0 will have the update mailed to them at no additional cost.

O&P practitioners need to start their compliance efforts now. Practices will have to develop notices of their privacy practices, create "business associate" contracts for vendors that receive protected health information, develop a privacy compliance program, and take other steps to meet the Privacy Standard's obligations by April 14, 2003.

NEW Addition to Academy’s HIPAA Compliance Plan: The Academy has also created a special 3-inch thick notebook of materials for the person selected as Privacy Officer. This special step-by-step notebook is in addition to the Model Compliance Plans offered on CD and is available only in paper form.

The Privacy Officer’s Supplement notebook is $99 and includes two PowerPoint presentations for staff training plus the Model Compliance Project Plan, a step by step listing of what the Privacy Officer needs to do. The notebook also includes a Project Register which documents a timeline for each step in the process, who is responsible, and when it is completed.

Members are encouraged to start immediately. Call the Academy Bookstore (301) 617-7805 to order the Model Compliance Plan today.

Academy Annual Meeting Plans Point to Outstanding Content

It was three years ago in San Diego when the Academy debuted its new format and structure for the Academy’s Annual Meeting and Scientific Symposium. The change has proven to be a huge success with members by combining symposia on controversial topics with solid education of instructional courses with case presentations, free papers, and manufacturers’ technical workshops. In addition, the Thranhardt Lecture Series featuring the top research papers in the profession and the Academy Awards program that honors the top achievers are perennial favorites.

The Academy returns to the same hotel, now named Sheraton San Diego, (located in the marina across from the airport) March 19-22. The names of members who register before the early-bird deadline of Feb 18 will be placed in a lottery for several prizes such as a free one-year membership, dinners at local restaurants, facial, massage, and a day pass to the Sheraton Fitness and Health Spa. The Academy is also lining up sponsors of prizes to be given during the exhibit hours.

Visit the Academy’s website (www.oandp.org) for program details as they develop.

Your Renewal Choice: 7 Months or 19

Most Members Choosing Extended Year Option

Renewal notices have been mailed offering members the option of paying dues for the next seven months or 19 months as the Academy transitions to a new Membership Year of July 1 to June 30. The shift will benefit those individuals who would prefer the dues renewal cycle not to come during the holiday period. About two-thirds of the renewing members are choosing the 19-month option according to Academy Executive Director Tom Gorski, CAE. This means they will not be billed again until June 2004. Despite ever increasing cost, the Board indicated there would be no dues increase in the foreseeable future. 2003 is the ninth year in a row the Academy has not raised dues. “We look to sources other than dues to increase our revenues," explained Frank H. Bostock, MBA, CO, FAAOP, Academy President. “Not many associations can say they haven’t raised dues in nine years."

Within the Academy . . .

• Julie Hayes has joined the Academy as its first Director of Development and Communications. Ms. Hayes, formerly executive director of OPAF before leaving to lead another foundation, Mathcounts, will spend much of her time helping the Academy find alternative sources of revenue.

• For the ninth year in a row the Academy has not raised practitioners’ dues. Tangible member benefits have tripled since 1994 when dues were last raised. The cost of providing services to members has increased. The buying power of that dollar amount has shrunk, but the Academy has NOT raised dues. Instead, it has focused its efforts to increase non-dues revenues.

• The Academy’s retention rate for practitioner members is 90 percent, a testament to those served by the organization.

• More than 60 members responded to a request to write targeted committee members in Congress regarding the funding of grants to O&P schools. The Academy Board appreciates the participation of those members in key states.

• The JPO is now listed on EMBASE, the Excerpta Medica database, a biomedical and pharmacological database that provides access to up-to-date information about medical and drug-related subjects. The database indexes 4,000 serial titles from around the world. Each record contains the full bibliographic citation, indexing terms and codes; 80% of all citations in EMBASE include author-written abstracts.