Utilisation of outcome measures by therapy teams in an NHS Trust

Abstract

Background: Outcome measures need to be used by allied health professionals (AHPs) to measure clinical effectiveness, as well as communicate with patients and commissioners.
 Methods: A survey of current use of outcome measures was conducted across acute and community therapies departments (dietetics, occupational therapy, physiotherapy and speech & language therapy services) within University Hospitals of Morecambe Bay NHS Foundation Trust (UHMBT).
 Results: There was a 17% response rate with 51 respondents completing the survey. 25% of respondents used outcome measures with every patient, 24% at least once per day, 22% at least once per week, and 29% rarely or never. Most therapists felt confident that they are able to score outcome measures accurately (mode rating for confidence: 8/10). However, 1 in 5 therapists reported low (≤5/10) confidence in using outcome measures. There was wide variation in the outcome measures used by respondents. The most commonly used outcome measures were the Berg Balance Scale (n=13) and the Therapies Outcome Measure (TOMS) – Multifactorial Conditions (n= 9). However there were 35 outcome measure tools cited as being used by only 1 respondent each. Themes from comments included: ‘considering change’ and barriers to outcome measure use as ‘COVID-19 impact’, ‘staffing pressures’ or ‘brief-intervention services’.
 Conclusion: Whilst a wide variety of outcome measures are used by therapy staff at UHMBT, they are not used with sufficient frequency to allow routine monitoring of clinical effectiveness. Being able to measure the impact of different models of service delivery would be particularly beneficial where service changes are implemented rapidly in response to the COVID-19 pandemic. Next steps could draw on evidence from previous studies by identifying suitable outcome measures (including those suitable for use in remote consultations), and developing a training programme to encourage the routine use of outcome measures in practice.