Message from the Vice-Chancellor for Clinic Affairs – EBCP in Action: NCQA Back Pain Recognition Program at the Palmer Clinics

Dear Colleagues:

Kurt Wood, D.C., Ph.D. Portrait In 2011, faculty clinicians and clinics at each of Palmer's campuses were received into the National Committee on Quality Assurance Back Pain Recognition Program (NCQA-BPRP), the first doctor of chiropractic program in the nation to be so recognized. The NCQA-BPRP acknowledges physicians and chiropractors who deliver superior care to millions of Americans who suffer from back pain. The Back Pain Recognition Program consists of 13 clinical measures and three structural standards such as the elements of the physical exam and advice for the return to normal activities. These requirements address the broad spectrum of low back pain and focus on underuse, misuse and overuse of treatment modalities. NCQA developed the BPRP requirements from widely accepted medical evidence, with significant input from physician specialists and health plan and employer representatives. NCQA-BPRP applicants abstract data from the charts of 35 low back pain patients per doctor and submit this information to NCQA for review along with documentation of patient education and evaluation of patient experiences. These data must meet a required threshold for the clinical measures and structural standards to receive recognition. Recognition by NCQA provides the Palmer Clinics with external validation of our doctors routinely using accepted elements of evidence-based clinical practice (EBCP) when evaluating and caring for back pain patients. This translates into a clinical education environment that promotes quality-focused, patient-centered and evidence-informed chiropractic care for our students to model.

Kurt Wood, D.C.

EBCP Concepts

Using Evidence to Advise Patients on Recommended Screenings – Lisa Killinger, D.C., Davenport Campus

Dr. Dana Lawrence portrait The Council on Chiropractic Education (CCE) requires all chiropractic colleges to include training on the recommended health screenings for common health concerns. CCE requirements aside, such screenings should be an important part of every health professional's practice, and chiropractors are no exception. While a chiropractor may choose not to perform blood tests or other screenings in their offices, it is essential that they recommend such screenings to their patients, and document the results in a patient's file. Health screenings do save lives and often identify disease early, reducing the need for extensive, invasive medical intervention. Such preventive strategies are quite congruous with chiropractic philosophy.


Evidence in Action

EBCP in NMS 1 and 2 – Michael VanNatta, D.C., Davenport Campus

michael vannatta portrait I've added EBCP materials to my NMS 1 and 2 courses. We review the evidence about which orthopedic/neurological and physical examination findings are more sensitive, specific and have better outcome data for upper and lower extremity radiating pain, and we review the evidence on nerve root compression from spinal disc bulge or herniation.

EBCP in Undergrad – Linda Carlson, M.S., R.T. (A.R.R.T.), Davenport Campus

Linda Carlson portrait I teach an undergraduate course entitled "Communication and Health Issues in Diverse Cultures." Attendees are a mix of DC students and undergraduates who have not yet started Palmer. In one of my PowerPoint presentations, I share EBCP info with the students and we talk about the following: how to research information; good search engines to use; how to determine if a study is relevant, etc. I then have the students give their own presentation on a specific culture as well as a health issue specific to that culture. Works great!

EBCP in Embryology – Judy Bhatti, D.C., Davenport Campus

I have 4 research case management sessions in my embryology class each term. I give a lecture on PICO (Patient- Intervention- Comparison- Outcome) and how to find peer-reviewed articles. This takes place during the first 3 weeks of class. I hand out a peer-reviewed article and a worksheet for them to complete during class in small groups sessions.

Throughout the trimester, I have them find peer-reviewed articles on certain congenital malformations and write 2-3 paragraphs on the treatment of the condition using a PICO format. I want them not only to find peer-reviewed articles, but to understand what other health care professionals are doing to treat the patient. This exercise helps students understand how providers use evidence-based information in a clinical setting, and how to collaborate with others in the health care setting.