Engaging the hearts and minds of clinicians in outcome measurement – the UK rehabilitation outcomes collaborative approach

Abstract

Purpose: This article explores the rationale for choosing the instruments included within the UK Rehabilitation Outcomes Collaborative (UKROC) data set. Using one specialist neuro-rehabilitation unit as an exemplar service, it describes an approach to engaging the hearts and minds of clinicians in recording the data. Key messages and implications: Measures included within a national data set for rehabilitation should be psychometrically robust and feasible to use in routine clinical practice; they should also support clinical decision-making so that clinicians actually want to use them. Learning from other international casemix models and benchmarking data sets, the UKROC team has developed a cluster of measures to inform the development of effective and cost-efficient rehabilitation services. These include measures of (1) “needs” for rehabilitation (complexity), (2) inputs provided to meet those needs (nursing and therapy intervention), and (3) outcome, including the attainment of personal goals as well as gains in functional independence. Conclusions: By integrating the use of the data set measures in everyday clinical practice, we have achieved a very high rate of compliance with data collection. However, staff training and ongoing commitment from senior staff and managers are critical to the maintenance of effort required to provide assurance of data quality in the longer term.

Implications for Rehabilitation

• With increasing attention focussed on the outcomes of rehabilitation interventions, the challenge remains as to how to engage clinicians to record outcomes consistently.

• This article describes the development and adoption of the UK rehabilitation outcomes collaborative (UKROC) data set in one exemplar setting.

• User friendly software, embedding the use of tools into everyday clinical decision making and ongoing commitment and leadership from senior staff and managers appear to play a key role in getting buy-in from clinicians.

Keywords::

• Rehabilitation
• outcome assessment
• clinical involvement

Acknowledgements

The authors gratefully acknowledge the hard work of the RRU staff in collecting the data presented in this study, and the co-operation of the patients to whom it belongs. Special thanks are due to Jo Clark for her role in co-ordinating data collection.

This article presents independent research commissioned by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research funding scheme (RP-PG-0407-10185). The views expressed in this paper are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health.

Declaration of Interest: Outcome measurement is a specific research interest of our centre. The RCS, NPDS, and the NPTDA were all developed through this department, but are disseminated free of charge. Professor Turner-Stokes, Hilary Rose and Heather Williams have variously authored the papers which describe their initial development and validation. Financial support for the preparation of this manuscript was provided by the Dunhill Medical Trust, the Luff Foundation.

Notes

¹The LTNC dataset may be downloaded from the NHS Information centre Website: http://www.ic.nhs.uk/services/datasets/document-downloads/long-term-neurological-conditions-ltnc-data-set.