Monday, 13 February 2017

The RCSLT Outcomes Project

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.

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 and by contacting RCSLT Outcomes Project Officer

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