Engaging the hearts and minds of clinicians in outcome measurement – the UK rehabilitation outcomes collaborative approach

Abstract

PurposeThis article explores the rationale for choosing the instruments included within the UK Rehabilitation Outcomes Collaborative (UKROC) data set. Using one specialist neuro-rehabilitation unit as an exemplar service, it describes an approach to engaging the hearts and minds of clinicians in recording the data.Key messages and implicationsMeasures included within a national data set for rehabilitation should be psychometrically robust and feasible to use in routine clinical practice; they should also support clinical decision-making so that clinicians actually want to use them. Learning from other international casemix models and benchmarking data sets, the UKROC team has developed a cluster of measures to inform the development of effective and cost-efficient rehabilitation services. These include measures of (1) “needs” for rehabilitation (complexity), (2) inputs provided to meet those needs (nursing and therapy intervention), and (3) outcome, including the attainment of personal goals as well as gains in functional independence.ConclusionsBy integrating the use of the data set measures in everyday clinical practice, we have achieved a very high rate of compliance with data collection. However, staff training and ongoing commitment from senior staff and managers are critical to the maintenance of effort required to provide assurance of data quality in the longer term.

A comprehensive psychometric evaluation of the UK FIM + FAM

“…We recovered 16 articles reporting on the psychometric qualities of the US FIM + FAM [2,7,14–27] and seven [9,10,12,28–31] on the UK FIM + FAM (six relating to the main scale and one to the EADL module). Appendix 1 summarises the existing literature and also highlights the contribution of new psychometric data presented in this article.…”

“…For this reason, the UK FIM + FAM has gained in popularity over the last decade, effectively taking over where development of the US version ceased and it is now the version that continues to be promoted and developed. It has recently been adopted as the principal outcome measure for neuro-rehabilitation in the UK national dataset for specialist rehabilitation (UK Rehabilitation Outcomes Collaborative [11,12]) and is increasingly being explored as an outcome measure for rehabilitation in other countries, including Australia, New Zealand, Europe and South America. It is therefore pertinent to examine its psychometric properties in the broader neuro-rehabilitation group in which it will be applied.…”

Categorisation of goals set using Goal Attainment Scaling for treatment of leg spasticity: a multicentre analysis

“…The setting was a regional specialised rehabilitation service (United Kingdom -Rehabilitation Outcomes Collaborative; designated hyper-acute and level 1) [24], with associated outreach and spasticity service. All patients receiving botulinum toxin injection for leg spasticity were included in the analysis and selection for treatment was undertaken based on clinical need.…”

Using the UKROC dataset to make the case for resources to improve cost-efficiency in neurological rehabilitation

“…The full 30-item UKROC dataset is described elsewhere [8] and details of its constituent tools are given in a separate article in this issue [1]. Staff are trained in the application of these tools through a national training programme.…”

“…In an earlier article in this issue, we presented the UK Rehabilitation Outcomes Collaborative (UKROC) database and the approach we have taken to engaging the hearts and minds of clinicians in data collection that will support outcome evaluation in relation to patients needs and the inputs provided [1]. However, data collection is only the first step.…”