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Exploring the implementation and use of outcome measurement in practice: a qualitative study
1Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Australia. jemma.skeat@mcri.edu.au
International Journal of Language & Communication Disorders
|September 14, 2007
Summary
Speech and language therapists can improve outcome measurement implementation by understanding how it fits their context. Aligning measures with practice requires addressing contextual fit and clinician control for successful use.
Area of Science:
- Speech-Language Pathology
- Health Services Research
- Clinical Practice Improvement
Background:
- Outcome measurement is crucial in clinical practice but challenging for speech and language therapists to implement successfully.
- Limited research exists on barriers and facilitators to successful outcome measure implementation.
Purpose of the Study:
- To develop a theoretical framework explaining the implementation and use of outcome measurement by speech and language therapists in clinical settings.
Main Methods:
- A qualitative, grounded theory methodology was employed.
- Data were collected through theoretical sampling, constant comparison, memo writing, and theoretical integration.
- 16 Australian speech and language pathology managers and clinicians participated.
Main Results:
- A two-stage framework emerged: 'trying on' outcome measurement to assess contextual fit, and 'aligning' it with the context.
- Successful alignment depends on clinicians' understanding of the measure, its data needs, the context, and having control over necessary changes.
- Strategies like 'tailoring' or 'accommodating' measures are possible but rely on achieving a good contextual fit.
Conclusions:
- The developed theory offers a framework for understanding outcome measurement use in clinical practice.
- Implementation requires clarifying the purpose of data, ensuring clinicians understand contextual fit, and managerial support for changes beyond clinician control.
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