A functional outcome measurement is a valid and reliable assessment that helps you evaluate the real changes that are occurring for patients in terms of the occupational therapy treatment you provide to them.
In basic terms, it involves doing a test, measuring the results, and using that test again during treatment to determine the outcome of the intervention – is it effective or not?
As an occupational therapist you will generally report functional data in the form of G-codes and modifiers in order to get reimbursement. Although you’re not required to use specific assessment tools, turning to evidence to see what really works can further your professional development and improve clinical outcomes for patients.
Using Evidence To Determine Functional Outcome Measurements
We’ve covered the topic of evidence practice quite a bit here at Rehab Alternatives because it is such a critical component of clinical practice, yet overall, it isn’t being used enough.
In terms of functional outcomes, you can also turn to evidence to gather information about what works and what doesn’t to help support what you do in practice.
For instance, a systematic review is considered the highest form of evidence, so search PubMed or Cochrane Library for papers that cover functional outcome measures for the specific patient segment you work with.
Let’s use this recent systematic review as an example. It’s about older adults at risk of activity or participation limitations. So if you work with older adults, this would be relevant to you.
From the abstract, you can gather that two particular measurements appear to be valid assessments in this target population:
- Functional Autonomy Measurement System (SMAF)
- The Assessment of Motor and Process Skills (AMPS)
When you dig a bit deeper and read some of the results, you’ll see that out of the 56 studies examined, a total of 28 different assessments were identified, so it’s interesting that only two have been deemed effective.
You might assume that this conclusion may have been reached because these two had the most amount of evidence, but this wasn’t the case. The Barthel Index (BI – C&W) assessment had the highest number of studies.
SMAF results were selected based on specific application in the target segment – older adults mainly in rehabilitation, community or hospital settings, the quality of the studies, and the level of measurement quality used in each study. These reasons were similar for AMPS.
As you can see, a review makes reaching a conclusion easier for you because the researchers compare multiple studies together to formulate more accurate conclusions about what is actually useful.
Applying Evidence-Base To Functional Outcome Measurements
Next you can uncover how you might use these assessments in clinical practice.
Looking further down in the discussion of the study, you first learn that:
“The SMAF focuses on activity limitation experienced in everyday activities, mobility, mental functions and communication. Assessment is based on what the subject does rather than what the subject could do with ratings scored on a five point scale from independent (0) to complete help (-3).”
Next, if you were to search “Functional Autonomy Measurement System (SMAF)” in Google, you can find additional research papers that label various activities and show you how to use the scale in clinical practice.
Here are some additional resources that outline how to apply this in practice:
- SMAF description and validation
- SMAF measuring disabilities in older people
- AOTA assessment measures and G-Code categories
- AOTA functional capacity evaluation