sally boa and joan murphy funded by nhs education scotland conducted by talking mats limited
TRANSCRIPT
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Sally Boa and Joan MurphyFunded by NHS Education Scotland Conducted by Talking Mats Limited
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Communication Matters outcome measurement project
Aims:“To provide information to service
providers and users in order to equip them with knowledge about tools that are appropriate to identify change associated with services and an individual’s communication skills”
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Points arising
• Confusion between assessment and outcome measurement
• Lots of Outcome Measures and assessments being used
• Why do we collect data?– To improve our individual practice– To provide feedback to others
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Literature review
• Methods
• Review questions and data extraction
• Findings
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Methods
• Rapid Review (Khangura et al 2012)
– “streamlined approach to synthesising evidence”
– Systematic search but a quick overview of existing research on a topic
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Review questions
• Which Outcome Measures (OM) are used in Health, Education and Social Services?• What are the purposes of the
measures?• How do these relate to AAC?• Are there any gaps in the literature?
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Papers screened• Google scholar, ASSIA,
Cochrane reviews– Total: 5121
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Full papers read• Google scholar: 5• ASSIA: 109• Cochrane reviews: 31
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Data extracted• Author; Year; Country; Population; OM • Outcome measures mentioned in papers– Total number: 72
• Categorisation:– Global/disease specific– Measuring what?– Valid and reliable?– Application to AAC?
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Global outcome measures
• AUSTOMS• Barthel• COPM• EQ5D• Expanded Disability status scale• FIM/FAM• Frenchay Activity Index• GAS• Nottingham Health Profile• TOMS
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Other measures• Disease specific
– Functional Assessment in Multiple Sclerosis (FAMS)– Aphasia Communication Outcome Measure
• Age specific:– Gross Motor Function Measure (Paediatric)– Mental Status Questionnaire (older people)
• Aimed at patients– COSSS Children's Overall Satisfaction with Schooling Scale– measure yourself medical outcome profile (MYMOP)
• Aimed at carers – Carers of Older People in Europe (COPE) Index – Family Impact of Childhood Disability measure
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Things to consider
• Validity and reliability of measures
• What are they measuring?
• Are they relevant to AAC?
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Survey
• Survey Monkey• Email • Twitter • Scotland, UK, International• Friday 1st – 8th March• Total responses 153
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Sector
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Geographical location
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Profession
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Extent of knowledge
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Purpose
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Outcome measure used Numbers
None used 58
Care Aims 9
TOMs 9
GAS 3
Talking Mats 3
CODES Framework 2
EFFC 2
Functional Communication 2
AFROM
Advocacy projects Outcomes 1
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Outcome measure used Numbers
Carer feedback 1
East Kent Outcome Scale 1
Emotion Talks 1
Goal setting 1
In house 1
Sarah Blackstone’s Circles 1
Sign List 1
Talking Points 1
VASES 1
WAB 1
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Frequency of use
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Value
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Why do we need Outcome Measures?
• I am not sure what an outcome measure is...• Demonstrates the value of interventions• ....
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Strengths
• It allows therapists to be outcome led and aim for functional, achievable goals that are personal to the patients
• It provides consistent approach across whole caseload
• Allows us to check as a multi agency team that we are all assessing clients similarly within reasonable limits
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Limitations
• No way of demonstrating outcomes with different types of AAC
• Difficult to share with service users• Not formally evidence based or standardised. Difficult
to prove effectiveness if measured against others• Too formal• Not consistently used in social settings• More difficult as intervention for higher tech users
usually cuts across a multi disciplinary/agency setting where it is harder to agree and measure outcomes
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Expert panel days
•Presentation of literature review and survey
•What is an Outcome Measure?
•Directions for future work
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Main points arising from expert panel days
• Agreed on what we mean by ‘Outcome Measure’
• Agreed on what is the best measure to use in AAC
• Identified the need for a measure to be workable across agencies
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Definition of an outcome measure
Outcome Measures should:Measure changeAre repeated over timeCan be used across clients, settings and disciplinesCan be used to give feedback to services, professionals, carers and clients (about what works as well as what doesn’t)Are robust/standardised/well respectedInform dischargeAre short and straightforward to useAllow for comparison with different types of AAC/No AAC
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Main contender for outcome measure in AAC
• TOMs AAC• (still in development – needs to be tested for
reliability and validity)
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Final report available on our websitewww.talkingmats.com