INTRODUCTION

The healthcare industry is punctuated with administrative and regulatory complexities that make it difficult for health systems to achieve what is now called the Quadruple Aim of healthcare: 1) improve the patient experience of care; 2) improve the health of populations; 3) reduce the per capita cost of healthcare; and 4) reduce clinician and staff burnout. [1] The complexities found in outcomes improvement are particularly challenging, as health systems measure and report on hundreds of these outcomes annually. Until recently, quality of care was hard to describe, measure, or report. A landmark in the quality movement in health care was the publication of the Institute of Medicine's (IoM) report 'to err is human: building a safer health system' in 1999. [2] Since the publication of this report, Quality Assurance (QA) in health care has steadily become a top priority for health care providers. In the United States, then called the Health Care Financing Administration, which was renamed the Centers for Medicare and Medicaid Services in July 2001, initially developed a set of quality indicators to assess the quality of care delivered to Medicare beneficiaries. [3] Other institutions have made their own set of quality indicators since then, which has led to a huge number of quality initiatives and thereby, to a completely new field in health care research. The IoM released a second report [4] where it proposed that the necessary changes should be translated into six dimensions of health care: safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity. [5]

Customer service in health care can be attributed to patient-centeredness or patient experience, which have become part of the accepted quality indicators of provided care. Patient-reported outcome measures (PROMs) fall within the patient experience outcome measure category. PROMs defined by the Food and Drug Administration as any report of the status of a patient's health condition that comes directly from the patient, without interpretation of the patient's response by a clinician or anyone else. [5] Patients can report on a number of domains that are important for evaluating an intervention including symptom experiences (e.g., pain, fatigue, nausea), functional status (e.g., mobility, bowel, or urinary functioning), wellbeing (e.g., physical, mental, social), quality of life, and satisfaction with care or with a treatment. [6-8]

Follow-up is the act of making contact with a patient or caregiver at a later, specified date to check on the patient's progress since their last appointment. Such information is useful for benchmarking, identify misunderstandings, answer questions, make further assessments and adjust approaches. In addition, follow-up helps to promote a good working relationship between the clinic and/or supplier entity and its patients. [9]

The purpose of this paper was to document the type and frequency of common data responses why an individual was listed as 'not active' before and after delivery for being assessed for a mobility device in the Functional Mobility Assessment (FMA) and Uniform Dataset (UDS) registry. [10]