New AT Recommendations paper published in JMIR

A new paper entitled: "Developing and Evaluating Digital Interventions to Promote Behavior Change in Health and Health Care: Recommendations Resulting From an International Workshop" has been published in the JMIR.

You can read the full article here: http://www.jmir.org/2017/6/e232/

Seminar: The ‘Perfect Patient Pathway’: an update from the Sheffield City Region health-technology Test Bed

This week Dr Steve Ariss, evaluation lead for The Perfect Patient Pathway gave a seminar on the progress of the regional Test Bed as part of the ScHARR Seminar Series.

Delivering and Evaluating Domestic Abuse Programmes: A Dissemination and Discussion

Dr Steve Ariss attended the Domestic Abuse Conference last week. 

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.

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.

University of Sheffield Short Courses Run by the Rehabilitation and Assistive Technology group and CATCH

Real-world evaluation course is run for the fifth time on the 2^nd and 3^rd March 2017. The course is focused on evaluation methods designed for complex health and social interventions/programmes.

Experiential Research Approaches (ERA) is a newly developed course. It is run for the first time on the 1^st and 2^nd February 2017. The course is focused on qualitative research with emphasis on context-dependent and values-based methods. 

Click here or here to find out more.

'Real-World' Evaluation: Ten Key Principles for Evaluating Complex Health and Social Interventions (previously EPTOCI)

Dr Steven Ariss and Dr Nasrin Nasr ran a short course about evaluating complex health and social interventions on Fridays 19^th and 26^th February 2016 for the third year. To read about this course, please click here.

Written by Dr Nasrin Nasr

Sheffield City Region was awarded an NHS TestBeds site for our Perfect Patient Pathway TestBed.

We are very pleased to announce, as you may see in the press (22.01.2016), that the Sheffield City Region was awarded an NHS TestBeds site for our Perfect Patient Pathway TestBed.

This was truly a group effort and we want to send a big thank you to everyone who contributed throughout the development of this successful bid.

 

Even more exciting: the Evaluation will be based in the RAT Group, with Dr Steve Ariss leading a small team.

Sir Keith Burnett, Vice Chancellor of the University of Sheffield said: "The University's role as a lead evaluator of the technology and system change is critical not only to ensure the Test Bed improves health in our region, but also provides good economic value. A flagship for the Sheffield City Region's Care 2050 initiative, it demonstrates our ability to deliver the technologies and systems necessary for affordable and sustainable future healthcare."
 

HS&DR - 08/1819/214: The Impact of Enhancing the Effectiveness of Interdisciplinary Working

Why are we asking for your actionable tools?

A project is being carried out at Sheffield Hallam University in conjunction with colleagues from CLAHRC YH, and is funded by NHS England to develop an online repository for actionable tools for active dissemination and implementation of research findings into practice. They are currently working with knowledge mobilisation experts linked to CLAHRC YH, NHS England,  practitioners and those responsible for professional development to derive a working definition of 'actionable tools', and are seeking out research outputs which could potentially be actionable tools. They will consult a governance team with end-user representation, to determine which candidate tools fulfil the criteria to be considered 'actionable' and hence can be included on the online repository.

The RAT Group have put forward some NIHR funded research outputs to be included.:

This paper is firmly directed at application of the principles: The ten principles of good interdisciplinary team practice.

The following is a resource that has been designed and used as an actionable tool:

InterdisciplinaryManagement Tool - Workbook (this is appendix #2 on the project page).

We have published an evaluation of the implementation of the tool:

Qualitative evaluation of the implementation of the Interdisciplinary Management Tool: A reflective tool to enhance interdisciplinary team work using Structured Facilitated Action Research for Implementation (SaFARI)

This project:

Secondary analysis and literature review of community rehabilitation and intermediate care: an information resource

Has a full report in the NIHR journals library.

Here are the chapters:

• Objective 1. To identify those patients most likely to benefit from intermediate care and those who would be best placed to receive care elsewhere
• Chapter 1. Which patients are most or least likely to benefit from intermediate care?
• Chapter 2. What factors are associated with increased hospital admissions for patients using intermediate care services? 
• Chapter 3. Factors predicting admission to institutional care among intermediate care service users 
• Chapter 4. What factors are associated with increased risk of mortality for intermediate care patients? 
• Objective 2. To examine the effectiveness of different models of intermediate care
• Chapter 5. What team-level factors are associated with the greatest benefits for patients in terms of health status? 
• Chapter 6. What is the cost-effectiveness of different models of care? 
• Objective 3. To explore the differences between intermediate care service configurations and how they have changed over time
• Chapter 7. How have intermediate care services changed over time? 
• Chapter 8. How have referral patterns changed over time and what is the relationship with patient outcomes? 
• Objective 4. Service toolkit
• Chapter 9. Development of a service toolkit to guide providers and commissioners of services

Each of these could provide evidence to inform actions for commissioners and service providers.

Notably, the NHS Benchmarking Network, National Audit of Intermediate Care (NAIC) (currently in its 5th year) has been using some of the recommendations from Objective 4 (especially the Therapy Outcome Measures), and automated data collection methods, which were pioneered as a result of continuation of this work.