RCSLT Outcomes Project TOMs CONNECT 17 th November 2016 Kamini - PowerPoint PPT Presentation

RCSLT Outcomes Project TOMs CONNECT 17 th November 2016 Kamini Gadhok Outcomes Project Sponsor, RCSLT CEO Kathryn Moyse Outcomes Project Officer, RCSLT Mark Bedwell Technical Partner, Different Class Solutions Ltd Dr Alison Stroud Head of Speech and Language Therapy, Aneurin Bevan Health Board

Context  Challenges across healthcare, education and social care with regard to outcome measurement  Use of terminology and consistency of definitions  Historical focus on inputs, processes and outputs  Outcome measurement not embedded - variable use of outcome measures, PROMS and PREMs  Few validated outcome measures available  Shift to outcomes-based commissioning in some parts of the UK  Focus on national policies and frameworks promoting improvement in health outcomes

RCSLT work on developing an approach  Developing consensus within the SLT profession about use of terminology:  Inputs  Processes  Outputs  Outcomes  Adopting the Theory of Change framework to articulate the contribution of SLT interventions to ultimate outcomes https://www.youtube.com/watch?v=wKcxkUBrDkY

RCSLT members’ ‘best fit’ criteria 4

‘Proof of Concept’ Pilot Aims To improve the collection of outcome data in order to 1. identify the impact of therapy for individuals with speech, language, communication and swallowing needs To investigate and minimise the burden of data 2. collection, collation and analysis on speech and language therapy service leaders and practitioners To investigate the practical challenges and benefits 3. of benchmarking for quality assurance and identifying variation in outcomes associated with different services

‘Proof of Concept’ Pilot Aims To investigate the value of TOMs aggregated data 4. reports in supporting service evaluation, quality assurance and business case development for individual services To evaluate the usability and value of a stand-alone 5. TOMs web-based application for SLT services (via direct data input or data transfer from an existing system) compared to data collection and reporting systems currently in use

The ‘proof of concept’ online tool  The online tool is being developed to support practitioners with:  Collecting and collating outcomes data using two methods:  Direct input of TOMs data into the online tool  Exporting of outcomes data from local systems to the online tool using a data transfer template  Evaluating and reporting outcomes 7

Key ● Adult Pilot ● Paediatric Organisations ● Adult and Paediatric 8

Pre-intervention Post-intervention

Data Upload Method Scoping options for the data upload method Option 1: XML Schema Option 2: Excel Template Option 3: Online Spreadsheet Spreadsheet upload with online Option 4: data mapping/validation

Wales strategic context

Only do what is needed…….. 50 45 40 35 Mar 30 June 25 Sept 20 Dec 15 10 5 0 2011 2012 2013

All TOMs Scales - Number and % change between admission and discharge Legend: Down Same Up Impairment Activity Participation Wellbeing Aneurin Bevan University Health Board Episodes = (23) Patients: (23)

Dysphonia: ABUHB/pilot comparison Legend: Down Same Up Impairment Activity Participation Wellbeing Aneurin Bevan University Health Board Episodes = (3) Patients: (3) Pilot Episodes = (837) Patients: (828)

Dysphagia: ABUHB/pilot comparison Legend: Down Same Up Impairment Activity Participation Wellbeing Aneurin Bevan University Health Board Episodes = (5) Patients: (5) Pilot Episodes = (6758) Patients: (6078)

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Key challenges Two key areas of challenge Information sharing and information governance 1. Data collection 2.

Actions to address challenges Information sharing and information governance  National stakeholder engagement (e.g. Information Governance Alliance, Information Commissioners Office, National Data Guardians) for advice and support on information governance  Developing resources to support SLT services engaged in the project to navigate local information governance documentation and engage local IG leads (e.g. Information Governance Resource Pack)

Actions to address challenges Information sharing and information governance  Developing resources to support SLT services with understanding legislation about information governance more broadly “ What can I share? Exploding the myths about information sharing” https://www.rcslt.org/news/webinars/rcslt_webinars Webinar in collaboration with the Information Governance Alliance (IGA) and Information Commissioner’s Office (ICO)

Actions to address challenges Data collection  National stakeholder engagement (e.g. NHS Digital, including UK Terminology centre)  Embedding standardised clinical terminologies within the online tool (ICD10/SNOMED)  Exploring different options for data export that will enhance the quality of the data and offer a more sustainable approach

Where are we now?  Refining the online tool and aggregated data reports in response to feedback from SLT services in the pilot  Iterative process  ‘Agile’ methodology  Currently, the RCSLT database contains outcomes data for 10,500+ complete episodes of care from six SLT services involved in the pilot (November 2016)  Independent evaluation conducted by Bristol Speech and Language Therapy Research Unit to evaluate the “benefit vs. burden”  RCSLT Board of Trustees will discuss next steps in December 2016

Thanks for listening! For more information, please contact: Kathryn Moyse RCSLT Outcomes Project Officer kathryn.moyse@rcslt.org https://www.rcslt.org/members/outcomes/RCSLT_outcomes_project 29

REFERENCE SLIDES CASE STUDY - PAEDIATRIC SPEECH AND LANGUAGE THERAPY SERVICE OUTCOMES

Change in TOMs scores between initial and final across each domain

Change in TOMs scores between initial and final across each domain

Change in TOMs scores between initial and final across multiple domains

Distribution of change in TOMs scores between initial and final across each domain

Average change in TOMs scores between initial and final across each domain