Background: Outcome measurement is essential to understand the impact of clinical interventions and the performance of services. Despite national and professional encouragement outcome measurement has failed to become embedded in clinical practice and its value continues to be questioned. Objectives: To address the outcome measurement debate within lower limb prosthetic rehabilitation and provide a critical synthesis of the evidence surrounding the discussion applied within the clinical context of the UK National Health Service (NHS).Study Design: Narrative review Methods: The authors drew on over 20 years clinical experience in prosthetic rehabilitation to synthesise and critique the outcome literature across a breadth of healthcare services. A narrative review methodology was selected to give voice to the clinical narrative thread.Results: This review addresses why we should measure health outcomes, the health care delivery and organisational scenarios in which outcome measurement can be beneficial and explores where lessons can be learnt for prosthetic rehabilitation from approaches in different specialities. The current outcome measurement literature within prosthetic rehabilitation is critiqued and we discuss the issues facing this field in the future.Conclusions: The dilemma of successful outcome measurement in clinical practice is multifaceted. Understanding and embedding value at every step is key to success. Addressing the questions of `why’, `what’ and `how’ we measure outcome will move us closer to a national consensus. Routine outcome measurement implementation at the clinical level must ensure data collection is valuable to clinical practice, makes use of IT solutions and has all important organisational buy in.
Thrombin generation and bleeding in cardiac surgery: a clinical narrative review
