1. Therapy Outcome Measure Louise Watson Rotational Lead Occupational Therapist NHS Greater Glasgow & AHP Team Lead Medical Clyde August 2012 Email address : louise.watson@ggc.scot.nhs.uk

2. Background Lack of outcome measures suitable for use in acute OT environment Monies via CHPO funded training Course run March 2012 Led by Prof Pam Enderby SALT- Thoroughly tested for reliability and validity Aids planning/reviewing of therapy goals

3. Therapy Goals Can we do anything about the disease or disorder Can we do anything about their independence Can we enable them to be more socially integrated Can we enable the person to be happier Can we make their main carer any happier

4. Choosing an Outcome Measure Relevance Validity Reliability Also Ease of use Communication

5. When to carry out TOM Only to be carried out after initial assessment Do not use on patients who will only be seen once by team Score can be redone if further information comes to light after initial scoring completed

6. Therapy Outcome Measure A multi-disciplinary method of gathering information on a broad spectrum of issues associated with therapy and rehabilitation It allows therapists to describe the abilities of a patient in four ways: 1. Impairment 2. Activity 3. Participation 4. Wellbeing Rating Severity Scale from 0 – 5 is given for each domain Administered at the beginning and again at the end of care

7. Dimensions Impairment – is the degree of the abnormality observed in terms of variance from the norm Activity – is what can you functionally do? ADL Participation- social participation in society, interaction with others Well- being – emotional aspects of condition

8. Scoring 5 point scale with options for ½ points. Scores are reliable as long as team members score within range of 1 point of each other Each dimension is scored giving 4 or 5 scores (not a total score)

9. Stephen Hawking Impairment Activity Participation Well- being

10. Rating Severity Scale -Impairment 0 The most severe presentation of this impairment 1 severe presentation of this impairment 2 severe/moderate presentation 3 moderate presentation 4 just below normal/mild impairment 5 no impairment

11. Rating Severity Scale – Activity 0 Totally dependent/unable to function 1 Assists/cooperates but burden of task/achievement falls on professional or caregiver 2 Can undertake some part of task but needs a high level of support to complete 3 Can undertake task/function in familiar situation but requires some verbal/physical assistance 4 Requires some minor assistance occasionally or extra time to complete task 5 Independent/able to function

12. Rating Severity Scale - Participation 0 No autonomy isolated, no social/ family life 1 Very limited choices, contact mainly with professionals, no social or family role, little control over life 2 Some integration, value and autonomy in one setting 3 Integrated, valued and autonomous in limited number of settings 4 Occasionally some restrictions in autonomy, integration or role 5 Integrated, valued, occupies appropriate role

13. Rating Severity Scale - Wellbeing 0 Severe constant 1 Frequently severe 2 Moderate consistent 3 Moderate frequent 4 Mild occasional 5 Not inappropriate (can have 2 scores here one for patient one for carer)

14. Scales There is a Core scale that can be used for all patient groups as described previously and adapted scales for specific medical conditions e.g. stroke, head injury, multi-factorial conditions (frail elderly)- see book for further details

15. Summary If you require any further information then purchase the book- Therapy Outcome Measures for Rehabilitation Professionals – Second edition Authors – Pamela Enderby, Alexander John, Brian Petheram Pam Enderby will run one day training courses for staff, she can be contacted directly for information on costs etc on email address : p.m.enderby@sheffield.ac.uk