RESEARCH ARTICLE Quality Indicators for Physiotherapy Care in Hip and Knee Osteoarthritis: Development and Clinimetric Properties W. F. Peter 1,2 * PT, P. J. van der Wees 3,4,5,6 PhD, E. J. M. Hendriks 7 PhD, R. A. de Bie 7 PhD, J. Verhoef 8 PhD, Z. de Jong 9 MD, PhD, L. van Bodegom-Vos 10 PhD, W. K. H. A. Hilberdink 11 MSc & T. P. M. Vliet Vlieland 1 MD, PhD 1 Department of Orthopaedics, Leiden University Medical Centre (LUMC), Leiden, the Netherlands 2 Reade, Centre of Rehabilitation and Rheumatology (formerly Jan van Breemen Institute), Amsterdam, the Netherlands 3 The Royal Dutch Society of Physical Therapy (KNGF), Amersfoort, the Netherlands 4 IQ Healthcare Nijmegen, the Netherlands 5 CAPHRI, Maastricht University, Maastricht, the Netherlands 6 Harvard Medical School, Boston, MA, USA 7 Centre for Evidence Based Physiotherapy, CAPHRI, Maastricht University, Maastricht, the Netherlands 8 Department of Physical Therapy, Faculty of Health, University of Applied Sciences, Leiden, the Netherlands 9 Department of Rheumatology, Leiden University Medical Centre (LUMC), Leiden, the Netherlands 10 Department of Medical Decision Making, LUMC, Leiden, the Netherlands 11 Allied Health Care Center for Rheumatology and Rehabilitation, Groningen, the Netherlands Abstract Objective. The aim of the present study was to develop process quality indicators for physiotherapy care based on key recommendations of the Dutch physiotherapy guideline on hip and knee osteoarthritis (OA). Methods. Guideline recommendations were rated for their relevance by an expert panel, transformed into potential indi- cators and incorporated into a questionnaire, the Quality Indicators for Physiotherapy in Hip and Knee Osteoarthritis (QIP-HKOA). Adherence with each indicator was rated on a Likert scale (0 = never to 4 = always). The QIP-HKOA was administered to groups of expert (n = 51) and general (n = 134) physiotherapists (PTs) to test its discriminative power. Reliability was tested in a subgroup of 118 PTs by computing the intraclass correlation coefficient (ICC). QIP- HKOA items were included if they were considered to be related to the cornerstones of physiotherapy in hip and knee OA (exercises and education), had discriminative power and/or if they were followed by <75% of PTs in both groups. Results. Nineteen indicators were derived from 41 recommendations. Twelve indicators were considered to be the corner- stones of physiotherapy care; six indicators had discriminative power and/or were followed by <75% PTs in both groups, resulting in an 18-item QIP- HKOA. The QIP-HKOA score was significantly higher with expert [60.73; standard deviation (SD) 5.67] than with general PTs (54.65; SD 6.17) (p < 0.001). The ICC of the QIP-HKOA among 46/118 PTs was 0.89. Conclusion. The QIP-HKOA, based on 18 process indicators derived from a physiotherapy guideline on hip and knee OA was found to be reliable and discriminated between expert and general PTs. Its ability to measure improvement in the quality of the process of physiotherapy care needs to be further examined. Copyright © 2012 John Wiley & Sons, Ltd. Keywords Quality indicators; physiotherapy; osteoarthritis; hip and knee *Correspondence: W. F. H. Peter, Leiden University Medical Centre, Department of Orthopaedics, P.O. Box 9600, 2300 RC Leiden, The Netherlands. Tel: +31 71 526 2750; Fax: +31 71 526 6743. Email: w.f.h.peter@lumc.nl Published online in Wiley Online Library (wileyonlinelibrary.com) DOI: 10.1002/msc.1041 Musculoskelet. Care (2012) © 2012 John Wiley & Sons, Ltd.