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Outcome measures in mental health occupational therapy workshop 18th June 2019 Royal College of Occupational Therapy National Conference
MOTION members Mandy Graham, Dr Mary Birken and Dr Catriona Connell hosted a conference workshop on outcome measures in mental health occupational therapy. A blog about the workshop can be found here: https://motionresearch.wordpress.com/2019/07/12/outcome-measures-in-mental-health-occupational-therapy-workshop/
Here’s the presentation and responses to questions we ask participants in groups and via Poll Everywhere.
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Poll Everywhere
At the start of the workshop we used Poll Everywhere, a mobile phone application, to ask three questions and gather their responses instantly.
Poll Question 1: What do you think of when we say outcome measures – 33 responses
Here’s what they said: -A large array of standardised, non standardised, hard stats -MOHOST
-Evidencing change, improvement – Inconsistent use
-Measurement of change / progress of intervention
-Baseline measures effectiveness of interventions -Monitoring performance
-Assessment used prior to activity and after an activity to gage success / person satisfaction / progress etc -Results of intervention
-How we measure how successful / effective something has been
-Measurement of change, standardised or non-standardised. Way of showing standard of service. -AusTOMS -Tools we can use to measure the effect our work has had
-The impact / success of intervention -Something to measure progress against
-Ensuring quality – Demonstrates effectiveness of intervention
-Not used enough -Measuring the efficacy of interventions
-Reporting on evidence -Measuring change / progress -Measuring the outcome of an applied -intervention -Demonstrating impact of an intervention, should be person centred -A way of evaluating an intervention -Measuring efficacy -Justify need for therapy -evidence base -How did we do? -Standardised vs non-standardised -MOHO
-Standardised -Measuring the success of interventions -Measures of effectiveness
Poll Question 2. Do you currently use outcome measures – 23 reponses
Always 17%
Sometimes 78%
Rarely 4%
Poll Question 3. What outcome measures do you use – 40 (the word cloud capped at 40) The larger the word, the more respondents used it.
We asked participants at the workshop the following questions. Participants were sitting in groups with colleagues with the same service user group and answered the questions together.
Below are their answers
Question 1 Who are you measuring outcomes for?
Acute Inpatient
-Future groups/service users -Unmet needs of service users
-Keep managers happy! -Helps me as an OT!- guides practice and intervention
-Evidence in other reports -Valuable to handover to next service/person/therapist/other OTs. -Helps me organise my thoughts as an OT in MDT.
Specialist (managers/students)
-Service user -Managers -Commissioners -Quality measure
-Self (self-efficacy) -MDT –reasoning -Research
-Public health -Funding
-Influence local and national developments-service improvements
-For carers -For local communities
Community
CCG-commissioning evidence
Service user- with involvement
Service effectiveness-staffing increase
Forensic
-Patients -Wider clinical team/MDT/OT service
-Care and Treatment Reviews -Ourselves- Commissioners
Question 2 What is the outcome you are trying to achieve?
Acute Inpatient
-Level of functioning -Discharge needs
Any other service referrals needed? -Justification for the service
-Unmet needs? -Interests and starting points?
-Level of improvement -Identifying day to day changes
-Client satisfaction with services
Justifying need for further intervention
Specialist (managers/students)
-Does it work? (find out if it works?) -Effectiveness
-Occupational change of all types -Occupational satisfaction
– Experience of client/carer -Quality of life
-Engagement -Participation -Value for money
-Impact of intervention (what difference does it make?)
-Targets that have been set
Forensic
-Reduction in risk -Change over time -Quality and efficacy of intervention?
-Perceived readiness -Overall occupational performance
-Attaining treatment goals eg able to come out of room, increase in pro social behaviours/strategies.
Community
-Impact on wellbeing -? it depends! What are service users goals?
-Optimizing function and occupational participation
-Indication of a positive result -Quality of life -That the intervention is successful
Question 3What outcome measures are available?
Acute inpatient
-MOHOST -OSA -OCAIRS -ESI –Observation -KAWA -Sleep diaries -Mood scales -APOM -Allens cognitive scale -AMPS
-Goal attainment scaling -COTES -Interest checklist
Specialist (mixed group)
-MOHOST -OSA -AMPS -GAS/GAS LIGHT -COPM
-ACIS -OTHER MOHO -Allen Cognitive Levels Screen
-Functional Independence Measure (FIM) -Functional Assessment tool (FAM)
-Therapy Outcome Measures (TOMS) -RECOVERY STAR -Non standardised
-Receipts-Timed and date stamped photos -Likert scales -Carer report
-Users report -Case studies and stories/verbal narrative
-Narrative occupational assessment (repeated) -Binary individualised measures GA/GNA/GPA
Community
-ACIS -Interest checklist -MOHOST -HONOS -WEMWBS
-AMPS -OCAIRS -MOCA -MMSC
-Depression scales -Recovery star
Forensic
-AMPS -MOHOST -APOM -VDTMOCA- ACIS -COTES
-OSA -TOMS -OCAIRS -GAD-7
-LSP life skills profile -Self rating scales -COPM
-Goal attainment scaling -VQ
On Tuesday, 13 March 2018 a OTalk twitter discussion was hosted by Tori on behalf of MOTION:
Topic: What does the term participation mean in mental health from an Occupational Therapy perspective?
Transcript for the Otalk listed below can be found here:
#OTalk 13th March – What does the term participation mean in mental health?
To generate wider discussions regarding participation as defined by ICF as an outcome for mental health and occupational therapy in mental health, three network members presented posters at two conferences in 2017; Royal College of Occupational Therapy Specialist Section- Mental Health and ENMESH (European Network for Mental Health Service Evaluation.
CONNELL, C., BIRKEN, M. & INMAN, J. 2017. The World Health Organization’s concept of participation: A proposal for assessing mental health and evaluating outcomes in real world settings. Conceptualising, measuring and influencing context in mental health care: From the individual to society. ENMESH Groningen, The Netherlands.
RCOTSS-MH conference poster 2017:
CONNELL, C., BIRKEN, M. & INMAN, J. 2017. Advancing intervention effectiveness research in mental health occupational therapy. Royal College of Occupational Therapists Specialist Section – Mental Health Conference. Birmingham, UK.
WFOT congress 2018 Poster:
Inman, J., Birken, M., Bannigan, K., Connell, C., Morris, K. & Smyth, G. 2018. Effectiveness of occupational therapy mental health interventions: Advancing research to develop the evidence base. World Federation of Occupational Therapy Congress, Cape Town, South Africa.
Survey of network members
In November 2017 MOTION carried out a survey of the then current membership with the aim of seeking MOTION members views on MOTION aims, and focus of the six current working groups, suggest new aims or working groups, and to identify their available time to commit to MOTION activities.
The survey was open between 27/11/17-19/02/18
16 members responded:
Demographics of respondents (n=16)
Lecturer 4
Course director 1
Post PhD Researcher 3
OT student 1
Mental Health Service User Researcher 1
PhD student 5
Clinician 5
AHP Darzi fellowship 1
Reader 1
Working groups signed up to
Participation as an outcome and measures of participation 13
Networking and dissemination 7
Economic evaluation within occupational therapy randomised controlled trials 6
Profile development & building website 1
Funding to support network activity 1
Important goals for MOTION identified by respondents that are not already stated
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Developing a research programme
• Developing a research programme for the creation of occupation-focused and/or based interventions with participation outcomes.
• supporting the development of programmes of research (my sense is that this is an issue, beyond the bounds of MOTION, for occupational therapy in general)
• Small monies bid to Deliver collaborative project as basis for larger funding bids. Publish these projects.
Influence development of mental health occupational therapy research
• Influence research priorities at RCOT and other mental health research funders
• Influence other researchers to conduct applied research, on outcomes and interventions
Broader membership
• Have family member/carer members however they would like to define themselves as a representative.
Develop collaborations
• Establishing collaborative partnerships with Universities and health providers
Directly support the increase of research capacity in Mental health occupational therapy interventions research
• Collating resources to strengthen practice.
• to increase research capacity within the mental health OT workforce
Summary of what respondents bring to the working groups (e.g. skills) that they have signed up to?
Connections with OTs involved in sleep research and practice across the globe
I work daily with MH clients, so it is easy to gather data from (&with) them
Understanding of children and young people’s mental health
Concept analysis work on concept of participation
Research skills:
design studies
apply for funding
systematic review skills
intervention development
Past member of an NHS REC
Knowledge of clinical academic networks
For our research in the field of cell dynamics and imaging, it is of central importance that scientists from different disciplines work together. The Cells in Motion Interfaculty Centre, therefore, is based on close cooperation between different faculties of our University as well as the Max Planck Institute for Molecular Biomedicine in Münster. These institutions have launched our research network and carry it together.
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In addition, various third party-funded and, in particular, interfaculty collaborative research projects as well as central scientific institutions of our University deal with topics that are closely linked to our field of research and involve members of Cells in Motion. By joining forces in the Cells in Motion Interfaculty Centre, we embed the specific scientific topics of these networks and institutions into a larger thematic context, and, at the same time, our network is an incubator for new collaborative initiatives. Together we further develop our scientific field as well as supportive offers and institutional structures.