OTH 209 Decision Making for Measuring Outcomes & Review of Measurement Properties

Stages of Measuring Client Outcomes

A structured approach helps guide decision-making and ensures accurate measurement.

Stage 1: Identification of Occupational Performance Issues by the Client

1)Purpose: Understand the client’s perspective on challenges and intervention goals.
2) Methods:
o Interviews, narratives, and self-reports.
o Both qualitative and quantitative assessments.
3) Outcome: Helps form hypotheses about performance difficulties

Stage 2: Identification of Occupational Performance Issues by Caregivers, Family, or
Friends(the issues they have)

In cases of cognitive impairments, communication difficulties or young children,
caregivers provide crucial insights/Input.
• Other members of the treatment team can also provide input

Stage 3: Further Assessment of Specific Occupational Performance Areas

1)Goal: Assess actual performance in occupations identified as important and
establishes a baseline for intervention and track progress.

2)Methods:
o Standardized assessment tools
o Clinical observation
• Helps us understand WHICH OCCUPATIONS are difficult for the client

Stage 4: Assessment of Environmental Conditions & Performance Components

Purpose: Identify specific performance components and environmental factors
that may be barriers affecting occupational performance.
• Methods:
o Assess environmental factors and personal abilities (e.g., strength,
cognition)
• Helps is to understand WHY the occupations identified in step 3 are difficult

Stage 5: Interpret Measurement Results

Key Considerations:
o What occupations are difficult for the client?
o What performance components, client factors and/or environmental factors
are barriers to occupational performance?
o Discuss results with clients, families, and the rehabilitation team.
o Determine intervention needs and effectiveness.

1. Reliability

• Ensures consistent and error-free measurement.
• Includes:
o Test-retest reliability – Consistency over time.
o Interrater reliability – Agreement between different raters.
o Intrarater reliability – Consistency of a single rater.
o Measurement error – Degree of accuracy.
o Internal consistency –Do similar test items produce similar results

Validity

Determines if an instrument measures what it intends to.
• Types:
o Content validity – Does it cover all aspects of what you want to measure?
o Construct validity – Does it measure the intended concept?
o Criterion validity – How well does the test measure the outcomes that it
was intended to measure?

Responsiveness to Change

• The ability of an assessment to detect improvement or decline over time.
• Essential for measuring therapy effectiveness.

Intervention Plan:

Set measurable and occupation-based goals.
o Choose interventions based on initial assessments

Intervention Implementation:

Ongoing monitoring of progress.
o Use SOAP notes for documentation.

Intervention Review:

Continual reevaluation and modification of intervention plans.
o Decide whether to continue, modify, or discharge OT services.

Key Takeaways

Outcome measurement = effective OT Interventions

Client-centered assessment- is Extremeley Important

Reliability, validity, and responsiveness are needed to choose right intervention

Goal setting, intervention planning, and
therapy effectiveness- is all influenced by outcomes measurment