In this era of evidence based physiotherapy, it is imperative that validated and reliable outcome measures are chosen, which will help evaluate the clinical effectiveness of our practice. In addition, outcome measures also serve as a great reflective tool towards the continuing professional development of any physiotherapist.
Before introducing an outcome measure to any physiotherapy practice, a number of steps need to be taken so that the therapists understand not only how to use the measure itself but also how the outcome measure will be incorporated into existing data collection systems and management of the service.
The steps in introducing any outcome measure to a service include:
1. Choosing the measure – The selection of an outcome measure needs to be based on research evidence of its reliability and validity. In addition, its applicability to the concerned population also needs to be taken into account. An outcome measure needs to be specific as well as sensitive to the particular condition.
2. Staff Training – All the therapists involved in the service need to be appraised with the outcome measure, provided any relevant information and training, explaining the need and expectations from the outcome measure.
3. Reliability testing – Once the training has been done, it is important that before the outcome measure is used on the patient population, it is trialled in a smaller sub group. The inter rater and intra rater reliability for the department needs to be considered. This provides an opportunity to iron out any issues which could potentially confound the results.
4. Data Collection and Analysis – From the trial, the data collected must be organized into appropriate information, which provides feedback as to the usefulness of the tool. It is important that the need for the outcome measure and its potential impact on clinical service is well understood by the team.
5. Implementation – Once the outcome measure has been trialled and has been found relevant and useful to the assessment of clinical outcomes, the tool can be implemented as a regular part of the assessment or management process.
6. Auditing – A regular audit process needs to be established to be able to assess the impact of using the outcome measure. This can be used as a process to compare the results of using the outcome measures by different therapists or if it is applicable, even in different conditions.
7. Feedback - It is imperative that the team is apprised the results of various audits, which help further reflect on usage of the outcome measures, any modifications needed in either the assessment or the management strategies, as applicable. It also helps in the continuing professional development of the physiotherapists through continued evaluation and reflection.