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Functional status change for patients with Foot and Ankle impairments

CBE ID
0424
Endorsement Status
1.1 New or Maintenance
Previous Endorsement Cycle
Is Under Review
No
1.3 Measure Description

This is a patient-reported outcome performance measure (PRO-PM) consisting of an item response theory-based patient-reported outcome measure (PROM) of change in functional status (FS) for patients aged 14 years and older with foot and ankle impairments. The change in FS is assessed using the FOTO Lower Extremity Physical Function (LEPF) PROM. The measure is adjusted to patient characteristics known to be associated with FS outcomes (risk adjusted) and used as a performance measure at the patient, individual clinician, and clinic levels to assess quality. Scores are reported on a 0 to 100 continuous scale with higher scores indicating better FS. The LEPF items relate directly to the Mobility and Self-care constructs within the Activities and Participation domain of the International Classification of Functioning, Disability and Health.
Additional information on the different development phases of the LEPF PROM are described in the testing attachment (section 1.5).

        • 1.14 Numerator

          The numerator is based on residual scores (actual change scores minus predicted change after risk adjustment) of patients receiving care for ankle or foot impairments and who completed the LEPF PROM. The numerator, as it applies to the 3 levels, is defined as follows:

          Patient Level: The residual functional status score for the individual patient.

          Individual Clinician Level: The average of residuals in functional status scores in patients who were treated by a clinician during the measurement period

          Clinic Level: The average of residuals in patients who were treated by a clinic during the measurement period.

        • 1.15 Denominator

          The target population is all patients 14 years and older with foot or ankle impairments who have initiated an episode of care and completed the LEPF PROM.

        • Exclusions

          Documentation stating patient has a diagnosis of a degenerative neurological condition such as ALS, MS, or Parkinson’s diagnosed at any time before or during the episode of care
          OR
          Patient unable to complete the LEPF PROM at Initial Evaluation and/or Discharge due to blindness, illiteracy, severe mental incapacity or language incompatibility and an adequate proxy is not available

        • Most Recent Endorsement Activity
          Measure Retired and Endorsement Removed Patient Experience and Function Spring Cycle 2021
          Initial Endorsement
          Last Updated
          Removal Date
        • Steward
          Focus on Therapeutic Outcomes
          Steward Organization POC Email
          Steward Organization Copyright

          See NQF document