In this era of health care accountability, a need exists for a new decision-making and documentation guide in physical therapy. The original Hypothesis-Oriented Algorithm for Clinicians (HOAC) provided clinicians and students with a framework for science-based clinical practice and focused on the remediation of functional deficits and how changes in impairments related to these deficits. The HOAC II was designed to address shortcomings in the original HOAC and be more compatible with contemporary practice, including the Guide to Physical Therapist Practice. Disablement terminology is used in the HOAC II to guide clinicians and students when documenting patient care and incorporating evidence into practice. The HOAC II, like the HOAC, can be applied to a patient regardless of age or disorder and allows for identification of problems by physical therapists when patients are not able to communicate their problems. A feature of the HOAC II that was lacking in the original algorithm is the concept of prevention and how to justify and document interventions directed at prevention.

Adult↗

PubMed2003

Application of the HOAC II: an episode of care for a patient with low back pain.

BACKGROUND AND PURPOSE: The HOAC II is a patient management algorithm designed, in part, to provide a conceptual framework for patient management for any type of patient seen by physical therapists. This case report illustrates how the HOAC II can be used in clinical practice. CASE DESCRIPTION: The patient was a 47-year-old woman with low back pain. The report describes the patient's examination, evaluation, diagnosis, prognosis, intervention, and outcomes within the context of the HOAC II. OUTCOME: The patient had measurable improvements in impairments, functional limitation, and disability following an intervention designed to resolve her impairments and functional limitations. DISCUSSION: This case report illustrates how the HOAC II can be used to assist in the management of a patient from admission to discharge. The report also demonstrates how use of a disablement model can add clarity to patient care.

Activities of Daily Living↗

PubMed2003