The implementation of and improvement in the musculoskeletal health questionnaire (MSK-HQ) scores at a MSK Outpatient Department.

Purpose

The MSK-HQ is a patient-reported outcome measure (PROM) that comprises of 14 questions and a score range of 0-56; with a higher score indicating a better MSK-HQ status. There is also a question which asks patients to indicate, in the past week, how many days they have engaged in physical activity that has raised their heart rate for 30 minutes or more (0 to 7 days). The MSK-HQ was recently implemented in the MSK Outpatient Department at London Road Community Hospital (University Hospitals of Derby and Burton NHS Foundation Trust). To date, no data for the department has been analysed to understand the success of its implementation and the change in score at the point of discharge compared to the known minimally important change (MIC) of 5.5. The aim was to therefore evaluate the MSK-HQ scores over a 1-year period for the MSK Outpatient Department.

16.3
The average improvement in MSK-HQ score from initial to discharge.
1.9 days to 3.6 days
The average physical activity levels of patients at their initial appointment to discharge.

Approach

The MSK-HQ was completed by patients at their initial and discharge appointment attending for physiotherapy and / or occupation therapy at the London Road Community Hospital between 1st January – 31st December 2019. The MSK-HQ scores were inputted into a database by a member of the administrative team; total scores out of 56 and the number of physical activity days were exported to excel. Data was analysed using descriptive statistics to determine the number of questionnaire’s completed and the average scores at initial and discharge.

Outcomes

Results: A total of 4065 initial and 966 discharge MSK-HQ scores were recorded during the stated time period. The return rate of discharge outcomes was 23.8%. The average initial score was 27.4 and the average discharge score was 43.7. The average improvement in MSK-HQ score from initial to discharge was 16.3. The average physical activity levels of patients at their initial appointment was 1.9 days and 3.6 days at discharge.

Conclusion(s): Completion of the MSK-HQ at initial appointment was over four times more successful than completion at discharge. Whether implementation has been successful is therefore questionable. For the available data, overall MSK-HQ scores increased at the point of discharge by nearly three times the MIC. Days patients report to have been physically active was also nearly doubled at the point of discharge.

Cost and savings

No additional costs.

Implications

In line with the growing concern regarding MSK health and lack of physical activity across the population, there is a clear focus to improve the MSK-HQ overall and physical activity scores for patients accessing outpatient MSK services. The need to improve data collection at discharge is a pertinent goal for the forthcoming year to ensure outcomes can be more accurately determined. An initial dataset has also been developed for comparison of MSK-HQ scores both within, and outside of the department.

Top three learning points

No further information. 

Funding acknowledgements

This work was unfunded.