Using Outcome Measures In Occupational Therapy By Pamela Eakin

Using Outcome Measures in
Occupational Therapy
Why use outcome measures in
occupational therapy
Professor Pamela Eakin
London South Bank
University
P Eakin
P Eakin
To support evidence-based OT
practice
“professional credibility requires the
demonstration of efficient and effective
interventions. The ability to determine a
patient’s functional status through a
standardised assessment is essential for
effective treatment planning and outcome
measurement” (Welch & Forster 2003)
To convince powerful others of the
value of OT
“..greater accountability…including improved quality of
care, increased transparency and monitoring of care
provided, value for money and improvements in the
information available to health care commissioners
and the public about the nature and consequences
of health care interventions”
(Fonaghy et al, 2004, p.13)
(Mental Health Outcome Measurement Initiative)
P Eakin
P Eakin
1

Drivers for the use of outcome
measures
Which outcome measures should we
use in OT
Government (legislation)
The Department of Health (policy)
Commissioners of services (funding and
priorities)
Managers (service budgets and targets)
Practitioners (resources, effectiveness)
Clients/patients (treatment and care)
Those which tell us (and others) how effective
our intervention is …
What are our intended outcomes
What about multiple outcomes
P Eakin
P Eakin
Complex interventions
Which outcomes should OTs
measure
Not always possible to:
“…identify or predict which [are] the active ingredients
that [bring] about particular outcomes. This is
because in complex interventions it is difficult to
entangle the specific, characteristic effects of
interventions from placebo or incidental effects such
as client expectations …”
(Patterson & Dieppe, 2005 cited in Creek, 2005)
Exactly the same intervention can be shown to
be either effective or ineffective depending
upon which outcome you choose to
measure.
The outcome is related to the intervention so
the outcome measure must be related to the
objectives of the intervention.
‘Cure’ versus ‘adaptation’
P Eakin
P Eakin
2

Measuring change
Scores in outcome measures
Outcome measures can be used to
demonstrate change (if any) resulting from
an intervention.
In order to measure change,
the assessment has to be standardised:
developed through research
tested for validity and reliability
Typically outcome measures have a scoring system
They generate numerical data which can be
manipulated (correctly or incorrectly!)
Numbers represent ‘concepts’ about client
performance. Decisions about client care are based
on these data.
If data misused or misunderstood – unsound decisions!
P Eakin
P Eakin
The ‘all in-one’ OT measure
References
No single measure covers all of OT
No measure is perfect – all can be criticised
Many measures out there – select carefully
- designed for your intervention
- do you understand the limitations
Do not rely on one measure only to measure
effectiveness – use a range.
Fonaghy P, Mathews R, Pilling S (2004) Report from the Chair of
the Outcomes Reference Group. The Mental Health Outcomes
Measurement Initiative. London: Royal College of Psychiatrists.
Welch A, Forster S (2003) A clinical audit of the outcome of
occupational therapy assessment and negotiated patient goals
in the acute setting. British Journal of Occupational Therapy
66(8), 363-368.
Patterson C, Dieppe P (2005) cited in Creek J, Ilott I, Cook S,
Munday C (2005) Valuing occupational therapy as a complex
intervention. British Journal of Occupational Therapy 68 (6) ,
281-284
P Eakin
P Eakin
3