Using outcome measures in occupational therapy can support evidence-based practice, convince others of the value of OT, and increase accountability. Outcome measures should assess how effective interventions are at achieving intended outcomes. However, it can be difficult to isolate the effects of complex interventions from other factors. OTs should use standardized, valid, and reliable outcome measures that are related to their interventions and objectives. While no single measure can cover all of OT, using a range of appropriate measures can help demonstrate any changes resulting from interventions.

1. Why use outcome measures in
Using Outcome Measures in occupational therapy?
Occupational Therapy
Professor Pamela Eakin
London South Bank
University
P Eakin P Eakin
To support evidence-based OT To convince powerful others of the
practice? 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)
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2. Drivers for the use of outcome Which outcome measures should we
measures 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)
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Which outcomes should OTs
Complex 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’
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3. Measuring change Scores in outcome measures
Outcome 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 client
In 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
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The ‘all in-one’ OT measure References
No 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 Outcomes
No 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 of
Many 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
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