Staff perceptions of using outcome measures in stroke rehabilitation.
OBJECTIVE
The use of standardised outcome measures is an integral part of stroke rehabilitation and is widely recommended as good practice. However, little is known about how measures are actually used or their impact. This study aimed to identify current clinical practice; how healthcare professionals working in stroke rehabilitation use outcome measures and their perceptions of the benefits and barriers to use.


METHODS
Eighty-four Health Care Professionals and 12 service managers and commissioners working in stroke services across a large UK county were surveyed by postal questionnaire.


RESULTS
Ninety-six percent of clinical respondents used at least one measure, however, less than half used measures regularly during a patient's stay. The mean number of tools used was 3.2 (SD = 1.9). Eighty-one different tools were identified; 16 of which were unpublished and unvalidated. Perceived barriers in using outcome measures in day-to-day clinical practice included lack of resources (time and training) and lack of knowledge of appropriate measures. Benefits identified were to demonstrate the effectiveness of rehabilitation interventions and monitor patients' progress.


CONCLUSIONS
Although the use of outcome measures is prevalent in clinical practice, there is little consistency in the tools utilised. The term "outcome measures" is used, but staff rarely used the measures at appropriate time points to formally assess and evaluate outcome. The term "measurement tool" more accurately reflects the purposes to which they were put and potential benefits. Further research to overcome the barriers in using standardised measurement tools and evaluate the impact of implementation on clinical practice is needed.


CONCLUSIONS
• Health professionals working in stroke rehabilitation should work together to agree when and how outcome measures can be most effectively used in their service. • Efforts should be made to ensure that standardised tools are used to measure outcome at set time-points during rehabilitation, in order to achieve the anticipated benefits. • Communication between service providers and commissioners could be improved to highlight the barriers in using standardised measures of outcome.
Greater Manchester & Cheshire Cardiac and Stroke Network, Stroke Rehabilitation Programme, Stockport, Manchester, UK. LouisaBurton@nhs.net
Louisa-Jane
LJ
Burton
Sarah
S
Tyson
Alison
A
McGovern
D001291:Attitude of Health Personnel; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000592:standards*; D010465:Perception; D017410:Practice Guidelines as Topic; D012015:Reference Standards; D012047:Rehabilitation Centers / Q000458:organization & administration; D000071939:Stroke Rehabilitation; D011795:Surveys and Questionnaires; D006113:United Kingdom