Get It on Paper
By Joe Young, CPO

In 1992, I was hired as an O&P technician. It only took a short time working to realize a major limitation of my efforts to meet deadlines: communicating with my practitioner.

Like many other facilities, we used a basic form—the prosthetic measurement sheet—to communicate. If this form is completed properly, it gives technicians a vast amount of valuable information, greatly increases productivity, and reduces re-fabrication.

But as a new technician, I received prosthetic measurement sheets that were incomplete. Consequently, I had to shelve negative models that could have been fabricated that day until the next one, when I would grab the practitioner and get the information I needed. But, two hours later, I’d discover another vital piece of information was missing. Or maybe the specifications we had discussed wouldn’t work.

Since I never could quite master the mystical art of practitioner mind-reading, I knew something had to be done to fix the problem. I knew my practitioner’s communication style was not flexible, so I decided to improve mine.

Creating the build sheet
I went home and made what I now call a prosthetic build sheet. The form, which was only one sheet, had three parts: a fabrication section, a parts list, and a simple blueprint of the prosthesis.

The fabrication section laid out a description of exactly how the socket would be made—for instance, whether it would have buildups over bony areas, how many layers of fiberglass, nylon or carbon I would use, and the grams of resin mixed and used.

The parts list identified everything, from the type of suspension to the number of cosmetic nylons, needed to fabricate the prosthesis.

I also drew a simple blueprint of a prosthesis (one for transfemoral amputees and one for transtibial amputees). I left spaces for every measurement I’d need—for instance, the build height of the foot or the degree of flexion required.

Finally, the form included the date the request was received, the date the prosthesis was required, and a place for the practitioner to approve the build laid out on the sheet.

The prosthetic build sheet allowed me to take the measurements and specifications the practitioner had taken and build a prosthesis on paper. If he had not taken measurements, I could show him exactly why I needed them. The form included all the information I needed, so I could get all my questions answered at once, understand the practitioner’s vision of the prosthesis to be fabricated, check build height clearances, order the correct components, and provide documentation for later reference.

The results
After using the build sheet for a year, I found the number of times I needed to follow up with my practitioner for additional information had dropped dramatically. He also began sending in fully-completed prosthetic measurement forms, because he knew why I needed these measurements (and that I would just come asking for them if they weren’t provided!) I also was able to identify clearance issues before ordering expensive feet, pylons, or shuttle locks that would not fit.

The documentation proved helpful, too. We began keeping the build sheets in the patient file, with components’ warranty cards attached. When a recall or reorder occurred, we knew the exact components, socket lay-ups and resin amounts we should use in fabricating the patient’s next prosthesis.

I continued to use this form until I decided to enter a practitioner program. As a practitioner, I used it to train new technicians. Now, I use it as a teaching tool in the Francis Tuttle Technician Program.

Use it yourself
Communication between technicians and practitioners in O&P facilities can be poor due to busy schedules, lack of contact, or bad communication skills. If some of the frustrations I’ve described sound familiar to you, download a free copy of the prosthetic build sheet at www.francistuttle.com/classes/ctp/op/presentations. I believe you’ll find that taking a few moments for this type of thoughtful planning will lead to more effective communication with the practitioners in your office and save you hours of frustration.

Joe Young, CPO, is director of the O&P technician program at Francis Tuttle Technology Center in Oklahoma City.