Quality indicators for occupational therapy: a scoping review.
Evaluation
Occupational therapy
Quality improvement
Quality indicators
Reimbursement
Journal
BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677
Informations de publication
Date de publication:
12 Sep 2024
12 Sep 2024
Historique:
received:
25
03
2024
accepted:
05
09
2024
medline:
13
9
2024
pubmed:
13
9
2024
entrez:
12
9
2024
Statut:
epublish
Résumé
Occupational therapists are increasingly asked to demonstrate the effectiveness, appropriateness, and efficiency of their interventions to funding bodies. However, the extent to which this is practiced and the health policy context within which such a practice is situated differs internationally. The aim of this scoping review was to establish which quality indicators are used internationally for this purpose. We conducted a scoping review, limiting our search to Europe and the English-speaking world. To search for suitable literature, we used specialized databases from medicine, health sciences, and related fields, including CINAHL Complete and MEDLINE, as well as free internet search via Google. Furthermore, we contacted national occupational therapy associations from several countries asking for access to documents found within this search that were only accessible to association members. The screening process identified 32 studies and documents from six national contexts. We identified and described process-level indicators, functional outcome indicators, one outcome indicator based on individual goal attainment (the Goal Attainment Scale, or GAS), and PRO-Ergo, a patient-reported experience measure (PREM). There was little information on the use of quality indicators to demonstrate the effectiveness, appropriateness, and efficiency of occupational therapy services to funding bodies in Europe and the English-speaking world that was openly available. The identified process indicators were in most cases not specific to occupational therapy interventions. Functional outcome indicators were highly specific to certain client groups or health conditions and partially appropriate for use in occupational therapy. The GAS was found to be a highly customizable measure which allowed an evaluation on body structure and function levels as well as activity and participation levels. PRO-Ergo was focused on the clients' subjective view and their experience with occupational therapy interventions. All identified quality indicators have advantages and disadvantages. Process-level indicators specific to occupational therapy could be a chance to foster the use of best practice methods. GAS and PRO-Ergo seem to be the most versatile assessment, allowing an evaluation on the level of activity and participation. Functional outcome indicators that cover a broad area of client problems may be useful additional quality indicators for some areas of practice.
Sections du résumé
BACKGROUND
BACKGROUND
Occupational therapists are increasingly asked to demonstrate the effectiveness, appropriateness, and efficiency of their interventions to funding bodies. However, the extent to which this is practiced and the health policy context within which such a practice is situated differs internationally. The aim of this scoping review was to establish which quality indicators are used internationally for this purpose.
METHODS
METHODS
We conducted a scoping review, limiting our search to Europe and the English-speaking world. To search for suitable literature, we used specialized databases from medicine, health sciences, and related fields, including CINAHL Complete and MEDLINE, as well as free internet search via Google. Furthermore, we contacted national occupational therapy associations from several countries asking for access to documents found within this search that were only accessible to association members.
RESULTS
RESULTS
The screening process identified 32 studies and documents from six national contexts. We identified and described process-level indicators, functional outcome indicators, one outcome indicator based on individual goal attainment (the Goal Attainment Scale, or GAS), and PRO-Ergo, a patient-reported experience measure (PREM). There was little information on the use of quality indicators to demonstrate the effectiveness, appropriateness, and efficiency of occupational therapy services to funding bodies in Europe and the English-speaking world that was openly available. The identified process indicators were in most cases not specific to occupational therapy interventions. Functional outcome indicators were highly specific to certain client groups or health conditions and partially appropriate for use in occupational therapy. The GAS was found to be a highly customizable measure which allowed an evaluation on body structure and function levels as well as activity and participation levels. PRO-Ergo was focused on the clients' subjective view and their experience with occupational therapy interventions.
CONCLUSIONS
CONCLUSIONS
All identified quality indicators have advantages and disadvantages. Process-level indicators specific to occupational therapy could be a chance to foster the use of best practice methods. GAS and PRO-Ergo seem to be the most versatile assessment, allowing an evaluation on the level of activity and participation. Functional outcome indicators that cover a broad area of client problems may be useful additional quality indicators for some areas of practice.
Identifiants
pubmed: 39267071
doi: 10.1186/s12913-024-11548-1
pii: 10.1186/s12913-024-11548-1
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1054Informations de copyright
© 2024. The Author(s).
Références
European Commission. Tools and methodologies to Assess the Efficiency of Health Care Services in Europe. European Union; 2019.
Kötter T, Blozik E, Scherer M. Methods for the guideline-based development of quality indicators–a systematic review. Implement Sci. 2012;7(1):21.
doi: 10.1186/1748-5908-7-21
pubmed: 22436067
pmcid: 3368783
World Federation of Occupational Therapists. QUEST Quality Evaluation Strategy Tool: An essential guide for using quality indicators in occupational therapy [Internet]. 2023. https://wfot.org/checkout/23421/30025 .
Mainz J. Defining and classifying clinical indicators for quality improvement. Int J Qual Health Care. 2003;15(6):523–30.
doi: 10.1093/intqhc/mzg081
pubmed: 14660535
Centers for Medicare & Medicaid Services. 2023 MIPS Quality Measures List [Internet]. 2022. https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2217/2023%20MIPS%20Quality%20Measures%20List.xlsx .
Arah OA, Klazinga NS, Delnoij DM, Asbroek AT, Custers T. Conceptual frameworks for health systems performance: a quest for effectiveness, quality, and improvement. Int J Qual Health Care. 2003;15(5):377–98.
doi: 10.1093/intqhc/mzg049
pubmed: 14527982
Parsons H, American Occupational Therapy Association. Response to congressional request for information (RFI) on the current state of the Medicare Access and CHIP Reauthorization Act (MACRA) [Internet]. 2022 [cited 2024 Jan 10]. https://www.aota.org/-/media/corporate/files/advocacy/aota-response-macra-rfi.pdf .
Peterson J, Pearce PF, Ferguson LA, Langford CA. Understanding scoping reviews: definition, purpose, and process. J Am Assoc Nurse Pract. 2017;29(1):12–6.
doi: 10.1002/2327-6924.12380
pubmed: 27245885
Peters MD, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil H. Scoping reviews. Joanna Briggs Inst Rev Man. 2017;2015:1–24.
Veritas Health Innovation. Covidence systematic review software [Internet]. Melbourne, Australia. 2023. Available from: www.covidence.org .
U.S. Centers for Medicare and Medicaid Services. What’s Medicare? [Internet]. 2023 [cited 2023 Aug 15]. https://www.medicare.gov/what-medicare-covers/your-medicare-coverage-choices/whats-medicare .
Centers for Medicare & Medicaid Services. Outcome Assessment Information Set Version E (OASIS-E) [Internet]. 2022. https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HomeHealthQualityInits/HHQIOASISUserManual .
Mor V. A comprehensive clinical assessment tool to inform policy and practice: applications of the minimum data set. Med Care. 2004;42(4 Suppl):III50–9.
pubmed: 15026672
Pardasaney PK, Deutsch A, Iriondo-Perez J, Ingber MJ, McMullen T. Measuring Inpatient Rehabilitation Facility Quality of Care: Discharge Self-Care Functional Status Quality measure. Arch Phys Med Rehabil. 2018;99(6):1035–41.
doi: 10.1016/j.apmr.2017.02.023
pubmed: 28363701
Trundy-Whitten L. New Patient Driven Payment Model from CMS [Internet]. 2018 [cited 2023 Jun 13]. https://www.berrydunn.com/news-detail/new-patient-driven-payment-model-from-cmswhat-to-expect-and-what-to-do .
AETNA. Occupational Therapy - Medical Clinical Policy Bulletins [Internet]. 2023 [cited 2023 Jun 13]. https://www.aetna.com/cpb/medical/data/200_299/0250.html .
OPTUM. Physical Therapy and Occupational Therapy Initial Evaluation and Reevaluation Reimbursement Policy [Internet]. 2020 [cited 2023 Jun 13]. https://www.myoptumhealthphysicalhealth.com/Documents/Reimbursement%20Policies/0044_PT_OTReimbursementPolicy.pdf .
Valenzano MFOXR. 2019 [cited 2023 Jun 13]. Is MIPS Good or Bad for PTs, OTs & SLPs? Your Medicare Update. https://www.foxrehab.org/mips-documentation-patient-care/ .
Centers for Medicare & Medicaid Services. Merit-based Incentive Payment System (MIPS) - Traditional MIPS Scoring Guide for the 2022 Performance Year [Internet]. Department of Health and Human Services; 2022 [cited 2023 Aug 15]. https://qpp-cm-prod-content.s3.amazonaws.com/uploads/1970/2022%20Traditional%20MIPS%20Scoring%20Guide.pdf .
Leland NE, Crum K, Phipps S, Roberts P, Gage B. Advancing the Value and Quality of Occupational Therapy in Health Service Delivery. Am J Occup Ther. 2015;69(1):p69010900101–7.
doi: 10.5014/ajot.2015.691001
American Occupational Therapy Association. Quality Payment Program (QPP) Merit-based Incentive Payment System (MIPS) Changes for 2020 | AOTA [Internet]. 2019 [cited 2023 Jun 13]. https://www.aota.org/advocacy/advocacy-news/2019/quality-payment-program-merit-based-incentive-payment-system-changes-2020 .
Byars G. Expressing the Unique Value of Occupational Therapy – Utah Occupational Therapy Association [Internet]. 2019 [cited 2023 Jun 13]. https://utahotassociation.org/expressing-the-unique-value-of-occupational-therapy/ .
Centers for Medicare & Medicaid Services. 2021 Quality Payment Program Experience Report [Internet]. Department of Health and Human Services; 2022 [cited 2023 Aug 15]. https://qpp-cm-prod-content.s3.amazonaws.com/uploads/2433/2021%20QPP%20Experience%20Report.pdf .
American Occupational Therapy Association. Section GG Self-Care (Activities of Daily Living) and Mobility Items [Internet]. 2022 [cited 2023 Jun 15]. https://www.aota.org/practice/domain-and-process/-/media/e85d779d45e14bdf8f4285abe75e1047.ashx .
Centers for Medicare & Medicaid Services. Coding Section GG Self-Care & Mobility Activities Included on the Post-Acute Care Item Sets: Key Questions to Consider When Coding [Internet]. 2023. https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/HomeHealthQualityInits/Downloads/GG-Self-Care-and-Mobility-Activities-Decision-Tree.pdf .
Santésuisse. Messprogramm in der Ergotherapie unterstützt kontinuierliche Qualitätsverbesserung [Internet]. 2021 [cited 2023 Jun 8]. https://www.santesuisse.ch/politik-medien/themen/qualitaet#content-tab-5 .
Kiresuk TJ, Smith AE, Cardillo JE. Goal attainment scaling: Applications, theory, and measurement. 1994.
ErgotherapeutInnen-Verband Schweiz. Qualität in der Ergotherapie [Internet]. 2022 [cited 2023 Sep 20]. https://www.ergotherapie.ch/verband/qualitaetsmanagement/ .
Petrig A, Ruth W. Siegenthaler-Tschanz, Karin, Roth, Felix, Deppeler, Sandro, Züge, Isabelle. Bericht der Paritätischen Kommission Qualität EVS/SRK/santésuisse 2020 [Internet]. 2021 [cited 2023 Sep 20]. https://www.ergotherapie.ch/download.php?cat=6JLvL2DYoAPKasSNvUf3Dw%3D%3D&id=42 .
Page J, Roos K, Bänziger A, Margot-Cattin I, Agustoni S, Rossini E, et al. Formulating goals in occupational therapy: state of the art in Switzerland. Scand J Occup Ther. 2015;22(6):403–15.
doi: 10.3109/11038128.2015.1049548
pubmed: 26087696
Ergotherapie Nederland. Pro-Ergo Vragenlijst - Ergotherapie [Internet]. 2017 [cited 2023 Sep 22]. https://info.ergotherapie.nl/file/download/default/1CF999424EEE153BDFDD1492DF344DFE/170705%20PRO-Ergo%20VERSIE%20juli%202017.pdf .
Hubert M. [The practice of needs assessment for the supply with technical aids in the Netherlands]. Prax Berdarfsermittl Zur Hilfsmittelversorgung Den Niederlanden. 2003;42(1):52–9.
National Institute for Health and Care Excellence. Indicator development programme: The NICE menu of indicators [Internet]. 2023 [cited 2023 Sep 20]. https://www.nice.org.uk/standards-and-indicators/indicators .
Ontario Health. Collaborative Quality Improvement Plan [Internet]. 2022 [cited 2023 Sep 20]. https://e-qip.ca/wp-content/uploads/2022/01/cQIP_OHT_Indicators_Technical_Specifications_EN.pdf .
Deutscher Verband Ergotherapie, Perspektiven DVE. / Ergotherapie 2029 [Internet]. 2022 [cited 2023 Jun 8]. https://dve.info/resources/pdf/dve/ziele/4632-perspektiven-2029/file .
Deutscher Verband Ergotherapie. Schwerpunkte des DVE 2023 [Internet]. 2022 [cited 2023 Jun 8]. https://dve.info/resources/pdf/dve/ziele/4892-dve-schwerpunkt-2023/file .
Deutscher Verband Ergotherapie. Geschäftsbericht 2013. DVE Aktuell. 2014;2014:01.
American Occupational Therapy Association. Occupational Therapy Practice Framework: domain and process—Fourth Edition. Am J Occup Ther. 2020;74(Supplement2):p74124100101–87.
Mahoney FI, Barthel DW. Functional evaluation: the Barthel Index: a simple index of independence useful in scoring improvement in the rehabilitation of the chronically ill. Md State Med J [Internet]. 1965 [cited 2024 Jan 9]; https://psycnet.apa.org/record/2012-30334-001 .
Federal Council. Health Policy Strategy of the Federal Council 2020–2030 [Die gesundheitspolitische Strategie des Bundesrates 2020–2030] [Internet]. Federal Office of Public Health. 2019. https://www.bag.admin.ch/dam/bag/de/dokumente/nat-gesundheitsstrategien/gesundheit-2030/strategie-gesundheit2030.pdf.download.pdf/strategie-gesundheit-2030.pdf .
Ergotherapie-Verband Schweiz. (2016). Leitbild des ErgotherapeutInnen-Verbandes Schweiz EVS. Ergotherapie-Verband Schweiz. https://www.ergotherapie.ch/download.php?cat=6JLvL2DYoAPKasSNvUf3Dw%3D%3D&id=8 .
Weise A. Ergotherapeutische Leitlinien Ergotherapie. 2016;2016(9):7.
Federal Council. Aims of the Federal Council for Quality Development for the years 2022–2024 [Ziele des Bundesrates zur Qualitätsentwicklung für die Jahre 2022–2024] [Internet]. Federal Office of Public Health. 2022. file:///C:/Users/balh/Downloads/BAG_Vierjahresziele_DE.pdf