Thanks to the @RCSLT Research & Outcomes teams, together with Professor Pam Enderby for contributing this excellent blogpost, packed with info, advice and resources 🙂
Outcomes: What, why and how?
All clinicians know that measuring therapy outcomes is important in establishing the impact of intervention and is therefore a central component of evidence-based practice and quality improvement. Commissioning can be outcomes-based, so speech and language therapists (SLTs) must demonstrate that they are delivering effective outcomes.
Ideally, ongoing monitoring of outcomes would encourage clinicians to reflect and evaluate their practice. This is true at an individual patient, therapist or service level. But therapists have difficulty in collecting and analysing their data on more than an individual patient basis, limiting its value in reporting and driving services forward.
Given this, the RCSLT strive to support SLTs across the UK to use outcomes data to drive change and improvement. The work includes the development of a digital tool (the ROOT) to collect outcomes data and create reports to serve a number of purposes, not least enabling individual therapists to compare their outcomes data with the national average.
Big data: outcome measurement and the evidence-base
Though often recognised as being at the pinnacle of evidence, RCTs tend to exclude individuals with certain personal, demographic or clinical attributes in order to reduce bias, and therefore are not always representative of our caseloads. Systematically collecting routine clinical data on all patients (‘big data’) provides an alternative source of information about the impact of therapy, which would place the information from RCTs into the broader clinical context. Big data and research findings can be appraised together to address gaps in the evidence base, and improve the quality of care.
The ROOT contains TOMs ratings for over 25,000 individuals who have received speech and language therapy. The dataset can be used to answer some clinical queries that are currently not provided in the research literature. For example, do people with stroke-related aphasia perform differently in therapy than those who have aphasia due to other neurological incidents? Further inspection of this data may allow us to speculate on why differences may occur.
Data driven improvement: facilitating change
Outcome measurement can illustrate the value of a service to clients and their carers, support local influencing, contribute to business-case preparation and bids for service development or change.
SLTs using the ROOT have used their data to demonstrate where change is needed. For example: by reviewing their ROOT data, the Lewisham & Greenwich Trust CYP SLT department identified that their phonology pathway was making less impact compared to the national comparator. They established a project to explore the reasons behind this difference to ensure that they were delivering quality intervention as part of their phonology pathway.
We are very keen to collect more of these success stories, so if you are a SLT and have used outcomes data to make a change please get in touch with us. The RCSLT have produced an optional template for these case studies, available here.
The RCSLT is delighted to witness the progress of SLTs in recognising the importance of measuring outcomes and the growing confidence in using them to demonstrate its value and support continuous improvement, which places the people we work with at the centre.
Other resources/links:
- Outcomes guidance pages https://www.rcslt.org/members/delivering-quality-services/outcome-measurement/outcome-measurement-guidance
- Webinar https://www.rcslt.org/webinars/are-you-root-ready-the-value-of-the-rcslt-online-outcome-tool
- ROOT registration https://rcslt-root.org/Public/Register
- ROOT information resources https://rcslt-root.org/Content/getting-ready-to-use-the-root & https://youtu.be/k723LCSaI_E
- Training https://rcslt-root.org/Content/root-training-resources