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 !