An evaluation of outcome measures for use by occupational therapists working in an inpatient Intermediate Care setting

Abstract

Executive Summary One of the most challenging decisions for an occupational therapist is selecting the most appropriate outcome measurement tool (RCOT 2015a; Law et al. 2017). Outcome measures are used to evaluate a client’s progress, and hence, should be valid, reliable, and able to measure the impact of the rehabilitation interventions on the individual clients. It is a Government recommendation and standard for all occupational therapists to measure the effectiveness of intervention in order to evidence the necessity of the profession and the service. Occupational Therapy outcome measurement tools are of significant importance due to the increased focus within the NHS on efficiency and economic performance, and the additional pressure placed on services and professions to evidence their value (Brindle 2015). Furthermore, these measures remain essential in demonstrating the efficiency of occupational therapy overall whilst ensuring maintenance of quality healthcare for individuals (Wendy 2013; RCOT 2017; NICE 2017). Intermediate care settings are newly established and are, therefore, under additional pressure to evidence their benefits. To date, a specific outcome measure has not been developed for use in an inpatient intermediate care service. Liberton hospital, a service based in Edinburgh, have unsuccessfully trialled a number of outcome measures. The trialled outcome measures failed to suit the service ethos and client group. However, these findings have influenced the design of this project evaluation, the aim of which is to explore outcome measures as a tool for occupational therapists and identify a suitable measure to be implemented in practice. An online questionnaire was created and distributed by email to occupational therapists in the service. Through the collection of qualitative and quantitative data, participants were able to voluntarily contribute their own knowledge and share personal experiences of using outcome measures. Five participants completed the questionnaire, and their responses highlighted the following points in relation to outcome measures:

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1. Outcome measures were identified as very important for practice. 2. A number of barriers were highlighted to administering outcome measurement tools in practice. The tools were felt too time consuming leading to increased paperwork. In addition, they were not occupation focused or practicable to service setting and required additional training. 3. Key areas, properties and functional skills required by the outcome measure to use within the service were identified.

The results of the questionnaire assisted the project lead in completing the following stage of the project which involved an exploration of literature in relation to outcome measures. Findings from the literature highlighted four outcome measures which contained suitable properties, meeting the requirements for use within the service. An outcome measure resource was developed to present the findings to the service.