Outcomes management practices in tiered school-based speech-language therapy: A Canadian example

Area of Science:

• Speech-language pathology
• Educational psychology
• Healthcare management

Background:

• Outcomes management in schools is complex due to community dynamics and tiered service delivery.
• Existing research on outcomes measurement primarily focuses on medical settings, creating a gap for school-based practices.
• Tiered service models require tailored outcomes and management strategies for diverse student needs.

Purpose of the Study:

• To explore how school-based speech-language therapists manage outcomes during the transition to tiered service delivery models.
• To identify the successes and challenges encountered by clinicians in outcomes management within school environments.

Main Methods:

• A secondary deductive-inductive content analysis was conducted.
• Qualitative interviews were held with 24 clinical managers and senior therapists in Ontario, Canada.
• Trustworthiness was ensured through iterative peer debriefing and reflexive journaling.

Main Results:

• Clinicians identified seven key outcomes: student progress, participation, stakeholder perspectives, buy-in, capacity building, responsiveness, and accountability.
• More challenges than successes were reported during the transition to tiered services.
• Challenges stemmed from organizational barriers, the shift to tiered models, and educational system philosophies.

Conclusions:

• School-based speech-language therapists manage diverse outcomes within tiered models, but significant challenges persist.
• Effective outcomes management requires tools that address tiered models, the educational context, and organizational specifics.
• Enhanced clinical-research collaboration and knowledge exchange are recommended to support practice.