11/17/2009
1
Whose outcome measures are
they anyway?
Druid Fleming
Residential and Rehabilitation Services
Camden and Islington Foundation Trust
Why bother?
Don't I have enough to do anyway?
We need clear outcomes to demonstrate:
• Recovery.
• That we are maintaining standards.
• That we are striving towards best practice.
• That we are effective.
• That we are economic.
• To keep us visible as a profession.
Different Perspectives
• Consumer/Service user
• Clinician
• Managers
• Commissioners
• Society
• ‘The collective’
Consumer
• Consumers will have choice!!!
• Personalisation agenda second phase underway.
• ‘Natural role’ of occupational therapy.
• Shift from interventions to assessment.
• Slade & Mc Crane • ‘Routine use of outcome measures did not improve subjective outcomes. Despite being
associated with a reduction in psychiatric admissions. ‘
• Dreem tool: MHF studies: The elements participants rated as most important –were not always the elements in which services performed best.
Clinical managers
• Performance measurement
• Concrete measures
• Measures indicate areas of good/poor
performance.
• Where to target resources
• Managing budgets
Commissioners
• Which service meets performance objects?
• Are services in line with government
strategies.
• Do services meet expressed individual user
needs?
• Do services meet assessed population user
needs?
• Which services deliver at the best price?
11/17/2009
2
Can Occupational therapists be
separated from the collective?
• “outcomes are a result of the collective input and that individual contributions are hard to separate out from teamwork” (Austin 93)
• An individual OT can still be part of a team, undertake same primary tasks, however does it differently.
(January 09 BAOT Hazel Parker)
• How are these benefits measured as outcomes Hazel?
• Team measures = invisible OTs ? Different measures?
• Collective view = same for consumers?
Can we learn from Star Trek?
Yes we can !
• Move from invisible part of collective to
individual member of a team.
• Clarify what we do as special.
• Identify outcomes that reflect the benefit to
users from occupational therapy.
• Support individuals in identifying their own
outcomes for recovery.
Yes we can
Why die young?
• Recognised co-morbidity mental and physical ill
health.
• More people die from cancer, heart attacks and
diabetes than suicide.
• There is a clear well being agenda:
• Improve physical assements + GP input.
• Smoking cessation
• Tackling obesity and poor diet
• Clear roles nursing and psychology
Role of OT ?
• A bit of every thing?
• Mapping?
• Sign posting?
• Or get out and do it?
11/17/2009
3
‘Candi-Cycles’ The A Team
Measuring the outcomes
• Identify the outcomes:
• Consumer: Individual narratives.
• Managers: Balanced score card:
• Commissioners: Outcome based research.
• Society: Positive publicity
• Collective: Will always be pissed off !
