A Clinical Audit of the Outcome of Occupational Therapy Assessment and Negotiated Patient Goals in the Acute Setting

Abstract

The increasing emphasis on quality and effectiveness in the National Health Service requires occupational therapists to provide evidence of accurate assessment and of the outcomes of interventions, supported by clear and concise documentation. With the merging of two acute hospitals came the opportunity for the occupational therapy services of Newcastle upon Tyne Hospitals NHS Trust to audit the process of functional assessment and documentation. A review of the occupational therapy service was undertaken. Standards were set to combine the Modified Barthel Index with negotiated patient goal setting. Practice was then changed to meet the standards. A subsequent audit considered the outcome of occupational therapy. The audit findings reaffirmed the acute occupational therapy focus on activities of daily living. The service identified that patients had low levels of disability according to Modified Barthel Index scores on discharge. Importantly, it was found that the reliability and validity of goal setting as a basic outcome measure was dependent upon therapists' ability to write specific quantifiable goals. The practice benefits included promoting patient involvement, enhancing the evidence base to practice, promoting consistent and effective functional assessment and documentation and reaffirming the unique contribution of occupational therapy as that of assessing a patient's level of function in activities of daily living objectively.