Quality indicators for occupational therapy: a scoping review

Area of Science:

• Health Services Research
• Occupational Therapy Practice

Background:

• Occupational therapists face increasing demands from funding bodies to prove intervention effectiveness, appropriateness, and efficiency.
• International variations exist in the practice of demonstrating service quality and the associated health policy contexts.

Purpose of the Study:

• To conduct a scoping review to identify quality indicators used internationally for demonstrating occupational therapy effectiveness, appropriateness, and efficiency to funding bodies.

Main Methods:

• A scoping review was performed, focusing on literature from Europe and English-speaking countries.
• Searches included specialized databases (CINAHL Complete, MEDLINE) and Google, supplemented by contacting national occupational therapy associations for member-exclusive documents.

Main Results:

• 32 studies and documents from six countries were identified, detailing process-level indicators, functional outcome indicators, the Goal Attainment Scale (GAS), and PRO-Ergo (a patient-reported experience measure).
• Limited openly available information exists on quality indicator use for demonstrating occupational therapy services to funders.
• Identified process indicators were often non-specific to occupational therapy, while functional outcome indicators were condition-specific. GAS and PRO-Ergo demonstrated versatility across different evaluation levels.

Conclusions:

• All quality indicators possess distinct advantages and disadvantages.
• Process-level indicators tailored to occupational therapy could promote best practices.
• Goal Attainment Scale (GAS) and PRO-Ergo are versatile assessments for evaluating activity and participation levels, with functional outcome indicators offering supplementary value.