Adapting the stroke therapy outcome measure for use by Multidisciplinary Teams: considering reliability

Area of Science:

• Rehabilitation Medicine
• Health Services Research
• Psychometrics

Background:

• The Therapy Outcome Measure (TOM) is a widely used tool with profession-specific scales based on the International Classification of Functioning Model.
• Effective communication and collaboration are crucial for successful stroke rehabilitation within multidisciplinary teams (MDTs).

Purpose of the Study:

• To develop and investigate the inter-rater and intra-rater reliability of a new Multidisciplinary Stroke TOM scale (MDT Stroke TOMs).
• To create a scale that describes stroke patient abilities and improves MDT communication and collaboration.

Main Methods:

• The MDT Stroke TOM Scale was developed by combining and rewording existing TOM scales.
• 150 Allied Health Professionals (AHPs) and nurses were trained in the scale.
• Inter-rater reliability was assessed by ten raters evaluating ten case studies.
• Intra-rater reliability was assessed by six raters reviewing three case studies at different time points.
• Reliability was quantified using intraclass correlation coefficients and smallest detectable change.

Main Results:

• Good to excellent concordance was observed between raters.
• Raters' scores demonstrated consistency.
• The MDT Stroke TOMs is currently in use across the South West London Stroke Network.

Conclusions:

• The MDT Stroke TOMs is psychometrically robust.
• The scale is expected to improve teamwork in stroke patient rehabilitation.
• Future research should explore its use in promoting interprofessional teamwork and communication in stroke rehabilitation.