OUTCOME MEASURES. NZAOT Conference 2012 Hamilton Linda Robertson

Transcription

1 OUTCOME MEASURES NZAOT Conference 2012 Hamilton Linda Robertson

2 Measurement Tools TASK: What assessment methods / tools do you use?

3 What is an Outcome Measure? It is an assessment or test that is known to accurately measure one or several attributes p149 Unsworth (2000) TASK: Describe 3 Characteristics of an outcome measure

4 Characteristics of instruments Valid Reliable Sensitive to change Clinically useful Feasible to use in given setting

5 What purpose do they serve? Enable comparisons: of outputs over time between different client groups Provide judgment of the worth of an intervention pre-post intervention comparison between patients with similar diagnosis Facilitate effective team communication

6 What do you want to measure? Team outputs Occupational therapy outputs Performance components? Occupational performance?

7 What setting are you in? Hospital; community; unidisciplinary; multidisciplinary What time constraints do you have?

8 Who has identified the need for outcome measures? The manager The team Yourself

9 Who will benefit? The occupational therapy service? The organization? The client? All of the above?

10 What will the benefits be? TASK: Identify 3 benefits to your service

11 Benefits of using Outcome Measures Why do we need to ensure that measurement is integral to our practice Provides explicit expertise Identifies the unique perspective of OT Informs others about our core knowledge Provides evidence of effectiveness Focuses on society needs - occupied citizens Law, Baum & Dunn (2005)

12 Imbedding Outcome Measures in the OT Process: Review long-term outcome Referral Discharge Re-evaluation On-going assessment Cues & Hypotheses Assessment PROBLEM ID Goal setting / Planning Intervention

13 Can patient goals be used as outcome measures? Write 1 goal for a client you are working with Evaluate this goal. What criteria did you use?

14 Patient Goals as outcome measures Quality of the goals: OTs struggle to articulate and set measurable goals Bowman, 2006

15 Challenges to incorporating measurement into practice Where do I start I don t have time Protocols used don t include measurement My team expects certain information from me Most out outcome measures do not apply to my clients What measure do I use? We have no money to buy assessments Law, Baum & Dunn (2005)

16 Examples of Measures OT measures COPM AMPS Allans Test AusTOMs Other measures GAS FIM (also the community version - Lawtons IADL) MMSE (also a shorter version) Barthel Index Life Satisfaction Qn

17 What measures are readily available? TASK: Name 3 outcome measures

18 Selected literature to describe outcome measures Parkinsons Related to conditions Stroke patients at home Upper limb recovery following stroke Children with Cerebral Palsy Substance use disorders Patients with long-term psychotic disorders

19 Selected literature to describe outcome measures Related to instruments Validity of the COPM A toolkit to measure geriatric outcomes Reliability of the COPM Therapy outcomes for allied health practitioners (AusTOMs)

20 Patient-Reported Outcome Measures (PROMS) PROMS provide a means of gaining insight into the way patients perceive their health and the impact that treatments or adjustments to lifestyle have on their quality of life. These instruments can be provided by a patient or individual about themselves, or by others on their behalf. PROM group, UHCE, Uni of Oxford

21 Different Types of PROMS GENERIC Applicable and comparable across a range of treatments or conditions Eg. Euro-Qol EQ-5D See: Nottingham Extended Activities of Daily Living (ADL) Scale CONDITION SPECIFIC Considered to be more sensitive to changes in health status Examples: Oxford hip score Oxford knee score Stroke Impact Scale.

22 Implementation Impact of Management Institutional changes to influence behaviour Eg. *Manager insisted that COPM and GAS had to be reported in all reports in Cerebral Palsy setting..

23 References Resource references for PG students: Bowman, J. (2006). Challenges to Measuring Outcomes in Occupational Therapy: a Qualitative Focus Group Study. British Journal of Occupational Therapy, 69(10), Unsworth, C. (2000). Measuring the outcome of occupational therapy: Tools and resources. Australian Journal of Occupational Therapy, 47, Law, M., Baum, C., & Dunn, W. (2001). Measuring Occupational Performance. Supporting best practice in occupational therapy. Thorofare, NJ: SLACK

24 Conclusions: There are many measures available select carefully; consider the purpose of the measure and the credibility of the tool. No measure is perfect No single measure covers all of OT Do not rely on one measure use a range