1. General Outcomes and Measures General Outcomes and Measures for SNOMED
for SNOMED OTs are interested in ...
• Collaborating, working with the person
• Holistic understanding of the individual and
Chris Austin their circumstances
Research and Development Officer • Facilitating, enabling, optimising self-reliance,
College of Occupational Therapists level of functioning, independence
• Occupational performance
• The individual’s view of their outcome
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What is an outcome Outcomes – for whom?
Example? • Client and carers
Fully independent in the community
• OT and supervisor
• Aim – to increase level of functioning?
• Manager
• (Goal – to live independently in the community
within 6 months) • Commissioner
• Construct –independent living in the community • Department of Health and politicians
• Measure – fully independent • Researchers
• Audit department
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Outcome Measure Tools Available Outcome Measures
• OTs use hundreds of standardised • Client-centred
Assessments, including many • Measure skills and body functions
Outcome Measure Tools • Measure tasks and activities
• Developed for specific measurement • Measure occupational performance and
purposes, without a national framework participation
• Difficult to compare Tools to identify
best one for a specific client group, or
measurement purpose.
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2. Client-centred Outcome Measures Skills and Body Functions
• Canadian Occupational Performance Measure • Assessment of Motor and Process Skills
(COPM) (AMPS)
• Goal Attainment Scaling (GAS) • Disabilities of the Arm, Shoulder and Hand
• Mayers Lifestyle Questionnaires 1 + 2 (DASH)
• Psychological Outcomes profile (PSYCHLOPS) • Mini Mental State Examination (MMSE)
• Occupational Case Analysis Interview and • Structured Observational Test of Function
Rating Scale (OCAIRS) (SOToF)
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Occupational Performance and
Tasks and Activities
Participation
• Assessment of Motor and Process Skills (AMPS)
• Canadian Occupational Performance
• Barthel Index Measure (COPM)
• Canadian Occupational Performance Measure • Community Dependency Index (CDI)
(COPM)
• Therapy Outcome Measure (TOM)
• Falls Efficacy Scale (FES)
• Functional Independence Measure (FIM)
• Therapy Outcome Measure (TOM)
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Electronic Care Records (ECRs) SNOMED Subsets
• Will provide access to a virtual patient record • Subsets collect together associated clinical
• Coded patient information will be routinely useful terms, e.g. Assessment Tools used by OTs
for secondary purposes (e.g. Research, audit, • To be used in drop-down lists in ECRs
commissioning, central returns) • To improve accuracy, consistency and speed of
• SNOMED is the NHS clinical terminology to be recording of key patient data
used in all ECRs • Need to be sponsored and developed by COT,
• SNOMED has few terms for outcomes that are with involvement of individual OTs and COT
meaningful to a patient. specialist sections.
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3. Outcomes Subset Mapping the Outcome Measures
• Project started in July 2008 • Now - Mapping Outcome Measure (OM) Tools
using the ICF as a framework
• National workshop in October 2008
• ... To identify individual Outcome terms
• Steering group set up in May 2009
• Outcomes terms will be extracted from the OM
• Piloting event in London in July 2009 maps (Winter 2009)
• Reference Group set up in late summer • Then ‘merged’ into a draft national set of
2009 outcomes for patients (Recorded by OTs)
• Consensus approach to be used to refine and
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agree the national subset (c. Spring 2010) 14
References - 1 References - 2
• Asher, I. E. (Ed.) (2007) Occupational therapy assessment tools: An
annotated index (3rd ed.). Bethesda, MD: AOTA Press. • Cook, S. (2008) Individualised Outcome Measures. Slides
• COT (2004) Guidance for the use of the International classification of from a presentation.
functioning, disability and health and the Ottawa charter for health
promotion in occupational therapy services. London: College of
• Enderby, P. John, A., and Petheram B. (2006) Therapy
Occupational Therapists. Outcome Measures for Rehabilitation Professionals:
• Creek, J. (2003) Occupational therapy defined as a complex Speech and Language Therapy, Physiotherapy,
intervention. London, College of Occupational Therapists. Occupational therapy, rehabilitation Nursing, Hearing
• Laver Fawcett, A. (2007) Principles of Assessment and Outcome Therapists. Chichester. John Wiley and Sons.
Measurement for Occupational Therapists and Physiotherapists: • Austin, C. and Clark, C.R. (1993) Measures of Outcome:
Theory, Skills and Application. Chichester. John Wiley and Sons.
for Whom? British Journal of Occupational Therapy 56(1).
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