Outcomes-and-measures-in-SNOMED-LLL event-london region-2009-Austin.pdf

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  • 1. General Outcomes and Measures General Outcomes and Measures for SNOMED for SNOMED OTs are interested in ... • Collaborating, working with the person • Holistic understanding of the individual and Chris Austin their circumstances Research and Development Officer • Facilitating, enabling, optimising self-reliance, College of Occupational Therapists level of functioning, independence • Occupational performance • The individual’s view of their outcome 1 2 What is an outcome Outcomes – for whom?Example? • Client and carersFully independent in the community • OT and supervisor• Aim – to increase level of functioning? • Manager• (Goal – to live independently in the community within 6 months) • Commissioner• Construct –independent living in the community • Department of Health and politicians• Measure – fully independent • Researchers • Audit department 3 4 Outcome Measure Tools Available Outcome Measures• OTs use hundreds of standardised • Client-centred Assessments, including many • Measure skills and body functions Outcome Measure Tools • Measure tasks and activities• Developed for specific measurement • Measure occupational performance and purposes, without a national framework participation• Difficult to compare Tools to identify best one for a specific client group, or measurement purpose. 5 6 1
  • 2. Client-centred Outcome Measures Skills and Body Functions• Canadian Occupational Performance Measure • Assessment of Motor and Process Skills (COPM) (AMPS)• Goal Attainment Scaling (GAS) • Disabilities of the Arm, Shoulder and Hand• Mayers Lifestyle Questionnaires 1 + 2 (DASH)• Psychological Outcomes profile (PSYCHLOPS) • Mini Mental State Examination (MMSE)• Occupational Case Analysis Interview and • Structured Observational Test of Function Rating Scale (OCAIRS) (SOToF) 7 8 Occupational Performance and Tasks and Activities Participation• Assessment of Motor and Process Skills (AMPS) • Canadian Occupational Performance• Barthel Index Measure (COPM)• Canadian Occupational Performance Measure • Community Dependency Index (CDI) (COPM) • Therapy Outcome Measure (TOM)• Falls Efficacy Scale (FES)• Functional Independence Measure (FIM)• Therapy Outcome Measure (TOM) 9 10 Electronic Care Records (ECRs) SNOMED Subsets• Will provide access to a virtual patient record • Subsets collect together associated clinical• Coded patient information will be routinely useful terms, e.g. Assessment Tools used by OTs for secondary purposes (e.g. Research, audit, • To be used in drop-down lists in ECRs commissioning, central returns) • To improve accuracy, consistency and speed of• SNOMED is the NHS clinical terminology to be recording of key patient data used in all ECRs • Need to be sponsored and developed by COT,• SNOMED has few terms for outcomes that are with involvement of individual OTs and COT meaningful to a patient. specialist sections. 11 12 2
  • 3. Outcomes Subset Mapping the Outcome Measures • Project started in July 2008 • Now - Mapping Outcome Measure (OM) Tools using the ICF as a framework • National workshop in October 2008 • ... To identify individual Outcome terms • Steering group set up in May 2009 • Outcomes terms will be extracted from the OM • Piloting event in London in July 2009 maps (Winter 2009) • Reference Group set up in late summer • Then ‘merged’ into a draft national set of 2009 outcomes for patients (Recorded by OTs) • Consensus approach to be used to refine and 13 agree the national subset (c. Spring 2010) 14 References - 1 References - 2• Asher, I. E. (Ed.) (2007) Occupational therapy assessment tools: An annotated index (3rd ed.). Bethesda, MD: AOTA Press. • Cook, S. (2008) Individualised Outcome Measures. Slides• COT (2004) Guidance for the use of the International classification of from a presentation. functioning, disability and health and the Ottawa charter for health promotion in occupational therapy services. London: College of • Enderby, P. John, A., and Petheram B. (2006) Therapy Occupational Therapists. Outcome Measures for Rehabilitation Professionals:• Creek, J. (2003) Occupational therapy defined as a complex Speech and Language Therapy, Physiotherapy, intervention. London, College of Occupational Therapists. Occupational therapy, rehabilitation Nursing, Hearing• Laver Fawcett, A. (2007) Principles of Assessment and Outcome Therapists. Chichester. John Wiley and Sons. Measurement for Occupational Therapists and Physiotherapists: • Austin, C. and Clark, C.R. (1993) Measures of Outcome: Theory, Skills and Application. Chichester. John Wiley and Sons. for Whom? British Journal of Occupational Therapy 56(1). 15 16 3