The QUEST to stay AT Home: Making changes that count and measuring outcomes that matter

Jessica Moller1, Rebecca McKay1
Gippsland Lakes Complete Health1

ABSTRACT

Background or Problem/ Issue:

Our community health occupational therapy (OT) team use a variety of outcome measures in daily practice which have not been routinely collected, collated or examined a meaningful way. With the increasing pressures from funding bodies for OT decision-making to be “reasonable, necessary and cost-effective” there was an unmet need for therapists to collate data to develop a more nuanced understanding of aspects of assistive technology (AT) devices and services that influence client satisfaction and uptake of devices. Therapists were also keen to know what elements of their service delivery was valued by clients and what areas needed to improve, with the overall goal of improving client care and reducing AT underutilisation or abandonment.

Method or What you did?

This quality improvement activity introduced routine post-intervention outcome measurement into OT community health clinical practice in two key areas of service provision, assistive technology and home modification practice.

Two tools were selected and implemented for OT post-intervention outcome measurement, The Quebec User Evaluation of Satisfaction with Technology (QUEST 2.0) and/or the Post Home Modification Satisfaction Survey (Aplin et al.,)

OTs now routinely collect these outcome measures at conclusion of episodes of care and results are collated to share common themes and address client feedback.

Results or Outcomes:

Implementation of formal outcome measurement as part of routine care has enabled consistent feedback/themes to be identified which was previously only gathered informally. Formal collation of data enables clinicians to review outcomes and address these for future clients therein improving processes of care.

As a result of introducing routine formal outcome measurement,

  • New patient information handouts in Easy English were developed to provide more simple information on the home modification process
  • Demonstration kits are now taken on home visits to support client input in choices on aesthetics, trial of non-slip textures and grab rail diameter etc for minor home modifications.
  • Client satisfaction with assistive technology is now measured and quantified. The 3 key themes that influence of clients satisfaction with their assistive technology device and services received will be presented.
  • Data is typically reviewed at 6-monthly intervals by senior OTs and changes made to processes where frequent themes present, to inform an ongoing quality cycle.

Conclusions or Practice Implications:

As OTs we understand from research and practice that provision of high-quality assistive technology devices and services can improve clients safety and well-being. Introducing routine outcome measurement into clinical practice enables us to better delineate what matters to our clients, this then supports continual quality improvement and results in better care and AT outcomes for our rural community.


BIOGRAPHIES

Jess is an Occupational Therapist who has been working in public community health settings in Victoria for the past 7 years.

Rebecca is a new-graduate Occupational Therapist who is in her first year of community health practice in rural Victoria.

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