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Using-outcome-measures-in-OT-LLL event-London region-Eakin.pdf Using-outcome-measures-in-OT-LLL event-London region-Eakin.pdf Document Transcript

  • Why use outcome measures in Using Outcome Measures in occupational therapy? Occupational Therapy Professor Pamela Eakin London South Bank University P Eakin P EakinTo support evidence-based OT To convince powerful others of thepractice? value of OT?“professional credibility requires the “..greater accountability…including improved quality of demonstration of efficient and effective care, increased transparency and monitoring of care provided, value for money and improvements in the interventions. The ability to determine a information available to health care commissioners patient’s functional status through a and the public about the nature and consequences standardised assessment is essential for of health care interventions” effective treatment planning and outcome (Fonaghy et al, 2004, p.13) measurement” (Welch & Forster 2003) (Mental Health Outcome Measurement Initiative) P Eakin P Eakin 1
  • Drivers for the use of outcome Which outcome measures should wemeasures use in OT? Government (legislation) The Department of Health (policy) Those which tell us (and others) how effective Commissioners of services (funding and our intervention is … priorities) Managers (service budgets and targets) What are our intended outcomes? Practitioners (resources, effectiveness) What about multiple outcomes? Clients/patients (treatment and care) P Eakin P Eakin Which outcomes should OTsComplex interventions measure?Not always possible to: Exactly the same intervention can be shown to“…identify or predict which [are] the active ingredients be either effective or ineffective depending that [bring] about particular outcomes. This is upon which outcome you choose to because in complex interventions it is difficult to measure. entangle the specific, characteristic effects of interventions from placebo or incidental effects such The outcome is related to the intervention so as client expectations …” the outcome measure must be related to the(Patterson & Dieppe, 2005 cited in Creek, 2005) objectives of the intervention. ‘Cure’ versus ‘adaptation’ P Eakin P Eakin 2
  • Measuring change Scores in outcome measuresOutcome measures can be used to Typically outcome measures have a scoring system demonstrate change (if any) resulting from They generate numerical data which can be an intervention. manipulated (correctly or incorrectly!) Numbers represent ‘concepts’ about clientIn order to measure change, performance. Decisions about client care are based on these data.the assessment has to be standardised: If data misused or misunderstood – unsound decisions! developed through research tested for validity and reliability P Eakin P EakinThe ‘all in-one’ OT measure ReferencesNo single measure covers all of OT Fonaghy P, Mathews R, Pilling S (2004) Report from the Chair of the Outcomes Reference Group. The Mental Health OutcomesNo measure is perfect – all can be criticised Measurement Initiative. London: Royal College of Psychiatrists. Welch A, Forster S (2003) A clinical audit of the outcome ofMany measures out there – select carefully occupational therapy assessment and negotiated patient goals - designed for your intervention? in the acute setting. British Journal of Occupational Therapy 66(8), 363-368. - do you understand the limitations? Patterson C, Dieppe P (2005) cited in Creek J, Ilott I, Cook S,Do not rely on one measure only to measure Munday C (2005) Valuing occupational therapy as a complex intervention. British Journal of Occupational Therapy 68 (6) , effectiveness – use a range. 281-284 P Eakin P Eakin 3