Occupational Therapy News OTnews April 2019 | Page 42

FEATURE OUTCOME MEASURES
Putting
Jamie Liddell and Pamela Enderby look at introducing the
Therapy Outcome Measure to a children’s therapy service,
including the challenges along the way and benefits
F
or the past two and a half years, and in
response to a recognised need to capture
the quality of therapeutic work with children
and families, the East Sussex Children’s
Integrated Therapy and Equipment Service (CITES)
has implemented the Therapy Outcome Measure
(TOM) into daily practice.
Outcome measurement is essential for
demonstrating the delivery of high quality and
effective services, as well as providing justification for
interventions (Royal College of Occupational Therapy
2013).
Because of the client centred and often
collaborative nature of occupational therapy, it can be
difficult to demonstrate the difference that clinicians
make to the lives of service users. The Therapy
Outcome Measure (TOM) is a tool that can enable
therapy services to establish the effectiveness of their
interventions.
It is based on the International Classification
of Function (ICF), which sits well with the holistic
ethos of the profession. The measure is divided
into four domains: impairment – the underlying
42 OTnews April 2019
condition; activity – ability to complete daily activities;
participation – social participation; and wellbeing –
emotional health.
The service user is scored at the point that their
therapy starts and then at the end of their treatment.
Intermediate ratings can also be generated at any
time during the intervention to provide extra data.
Therapists within the team set up a steering group
to plan the implementation of the measure. Following
a successful pilot, training was provided across
the service in December 2016. The tool was then
implemented by clinicians.
To date, figures have shown encouraging trends in
terms of improvements for children and their families.
The occupational therapists have paid particular
attention to the activity and participation scores, but
it is evident that the domains all impact on each
other.
Therapists have reported finding the scoring
process quick and easy, which has been essential
in terms of practical issues and time management.
Cases are rated via an 11-point ordinal scale, ranging
from mild impairment up to severe.
first