This document discusses outcome assessment for pulmonary rehabilitation programs. It outlines several key domains to measure for outcomes, including health, clinical, behavioral, and service domains. Clinical domains focus on measuring decreases in dyspnea and fatigue and increases in exercise performance and functional status. Outcomes should be measured before and after rehabilitation to evaluate a patient's progress and the program's effectiveness. Long-term follow up is also important to reinforce skills and support learned in rehabilitation. Regular outcome assessment provides feedback on patients and the overall program.

1. Outcome Assessment
Presented by:
Sumi Varghese
M.Sc. Respiratory Therapy- Adult respiratory care

2. Outcome Assessment
Decrease in
dyspnea and
fatigue
Increase in
exercise
performance
Improvement
in functional
status
Improvement
in health
status

3. Reasons For Outcome Assessment
Documents effectiveness of the intervention
Patient – to – patient variability
Direct positive feedback- increase moral and motivation
Provides valuable feedback on the effectiveness of various
components of PR programme
Third party payers & facility administration
Success of individual PR program
Feedback information to referring physician

4. Timing of patient centered outcome
measurement
1. PRE TO POST REHABILITATION
- To evaluate progress of the patient & effectiveness of
PR program
- By measuring specific outcomes
 Immediately before
 Shortly after end of the program
- Same instrument to be used to document change

5. Timing of patient centered outcome
measurement
2. LONG TERM ASSESSMENT OF OUTCOME
- Longitudinal assessment of outcomes
- Includes :
Reinforcement
of ongoing skills
Self care skills
Education
support

6. DOMAINS FOR OUTCOME
MEASUREMENT

7. Health domain
HRQoL
Morbidity
Mortality

8. Clinical domain
Reflects physical & psychological changes resulting
from PR
Measurable outcome areas
- Dyspnea and fatigue
- Exercise performance
- Psychological variables

9. • Rating exertional breathlessness
during specific task
• Rating overall level of
breathlessness during daily activities
Dyspnea
• Field tests
• Lab tests
Exercise
performance
• Screening
• Cognitive function
• Functional performance
Psychological
status

10. Behavioral domain
Potential outcome areas
Knowledge of educational objectives (determined by testing)
Success with smoking cessation efforts
Adherence to diet instructions
Adherence to medications
Adherence to exercise prescriptions
Adherence to post rehabilitation exercise directions
Adherence to breathing retraining
Supplemental oxygen use
Success with coping mechanisms
Success with energy conservation techniques
Success with relaxation and stress management techniques
Success with pacing techniques

11. Service domain
PR is a customer service program
Delivers excellent customer services to patients and their
families as an extension of the physician’s management

12. Summary

13. References
American Association of Cardiovascular and Pulmonary
Rehabilitation. Outcome assessment. In Guidelines for
Pulmonary Rehabilitation Programs.; 2005. p. 59-66