8.10 Outcome measurement

An outcome measure is a tool to determine a person’s progress, using the same method over two or more points in time [69, 70]. The use of outcome measures is important from the perspective of the person, the health professionals and the funder. Patient-reported outcome measures (PROMs) are tools that provide a way of measuring health outcomes from the person’s perspective (and therefore are person-centred), rather than health professional’s perspective. The use of PROMs provide an important, accurate and standardised way on complex outcomes such as functioning, activities and participation [71-73]. All the tools recommended in section 8.9 to support screening the person are PROMs.

From the perspective of the person with an amputation, their family, and the health professionals and support workers involved, measuring progress and outcomes is helpful for:

• making decisions on treatment and for monitoring change (no change, improvement or deterioration) • knowing what is and what is not working (for the continuation or cessation of treatment) • identifying factors that may compromise treatment outcomes (e.g. psychosocial concerns) • providing feedback to the person on progress towards their goals • supporting the engagement and collaboration of the person as an agent in their own treatment, rehabilitation and progress (particularly when it is a self-reported outcome measure or one where the person is responsible for measuring things like frequency and time spent on activities). Measuring outcomes also provides information for the health professionals and funders to make decisions about what needs to be changed with the person’s rehabilitation and therapy programs, and the next steps. Outcome measures also support the reasoning behind the type of equipment (including prosthesis), treatment and rehabilitation, community services and supports that are considered reasonable and necessary for the person and their family.

From the funder’s perspective, measuring outcomes:

• contributes to greater details and understanding of the person and their context • provides transparent information that assists with decision-making on planning for the person and funding requests • provides transparency and supports reasoning for treatment, rehabilitation and care requests • provides relevant data that is useful at the population level and scheme level.

Recommendations

14 Health professionals should use and report on reliable and validated outcome measures as best practice.

15 The person who administered the outcome measure is responsible for following up with actions or referrals where indicated, and for providing feedback to the person and other team members, e.g. by phone call or referral. Grade

A

Consensus