The
RCSLT Outcomes Project
The Royal College of Speech and Language Therapists
(RCSLT) has embarked on an innovative and ambitious project to support speech
and language therapists with delivering and measuring effective outcomes.
In 2013, RCSLT members devised a list of criteria to
identify an existing outcome measurement tool to enable comparable, valid and
reliable data to be gathered from across the profession. Over 60 outcome
measures, frameworks and systems commonly used by speech and language
therapists (SLTs) were appraised against this set of criteria. Therapy Outcome Measures for Rehabilitation
Professionals 3rd Edition (TOMs, Enderby and John, 2015) was selected as
the ‘best fit’.
TOMs scales address four dimensions of an individual
in line with the International Classification of Functioning, Disability and
Health (WHO, 2007).
·
Impairment – the
severity of the presenting difficulty/condition
·
Activity – the impact
of the difficulty on the individual’s level of independence
·
Participation –
impact on levels of social engagement and autonomy
·
Wellbeing –
impact on mental and emotional wellbeing
In 2015, the RCSLT Council approved the development
of a proof of concept online tool to support collection of TOMs data.
Proof of concept pilot
The RCSLT Online Outcome Tool (ROOT) is a stand-alone
system that has been developed to collect and collate outcomes data. Clinicians
can use the tool to record and monitor outcomes for individual service users
and access reports that show change over time in association with SLT
interventions.
Users of the tool can input TOMs data for service
users directly into the ROOT via a web-based application, or upload data that
has been extracted from databases within existing electronic systems. The ROOT
collects data about the individual’s age, gender and diagnoses and TOMs ratings
at different points in time.
The ROOT aggregates data recorded by an SLT service
and generates reports. These can be used by service managers to evaluate the
outcomes delivered and support them with monitoring outcomes for specific
clinical groups and evidencing the impact of SLT. Filters can be applied to the
reports to drill down to specific clinical groups at the required level for
data analysis and reporting.
Adult and paediatric SLT services across the UK are
currently piloting the use of the ROOT, and the software is being developed in response
to their feedback.
Project evaluation
An independent evaluation of the proof of concept
pilot has been undertaken with services that are piloting ROOT (November 2016).
Feedback from the pilot sites has indicated that ROOT, particularly the
aggregated data reports, offers the potential to add value to SLT services, but
further time is required to embed the use of ROOT into services to allow
further testing. It was suggested that the reports generated by ROOT offer the
potential:
·
to identify gaps
in service and impact of resources
·
to evaluate
service delivery models and specific therapeutic approaches
·
to benchmark
against other services (offering the opportunity to compare and improve
services, and inform commissioners)
Following consideration of the findings and
recommendations of the independent evaluation, the RCSLT Board of Trustees approved
an extension of the pilot for a further six months (December 2016). This will provide
an opportunity for the SLT services engaged with the pilot to gain more
experience of using the ROOT to collect data and generate and test the reports.
During this time, the following key areas will be explored:
·
Further
development of ROOT
·
Method of data
collection - Direct data entry / export method
·
Aggregated data
reports and their uses
·
Development of
resources e.g. to support use of the ROOT, information governance
Phase 2: Framing TOMs as part of other resources available
In parallel to the proof of concept pilot, the
outcomes project steering group has recommended the initiation of ‘phase 2’ of
the project. This phase of the project will include scoping the use of other
sources of data and the available resources, outcome measures and frameworks
that can be used alongside TOMs to evidence the impact of SLT services.
References
Enderby, P. and John, A. (2015) Therapy Outcomes Measures for Rehabilitation Professionals, Third
edition, J&R Press Ltd.
Further information
Information about the RCSLT’s journey with outcome
measurement is available on the RCSLT webpages https://www.rcslt.org/members/outcomes/RCSLT_outcomes_project and by contacting RCSLT Outcomes Project Officer kathryn.moyse@rcslt.org.
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