Enhancing Client Outcomes: The role of OT in Case Management through measurable results
by Paul Cooper, Professional Head of OT at The OT Practice
As all case managers know, occupational therapists play a pivotal role in improving the lives of their clients. With the growing demand for occupational therapy in an increasingly competitive healthcare sector, we recognised the need to better demonstrate the tangible results our therapists achieve in enhancing clients' independence and wellbeing. With this in mind, at the end of last year, we strengthened and enhanced our approach to gathering outcomes.
Why outcomes matter?
“A health outcome can be defined as ‘a change in the health status of an individual, group or population which is attributable to a planned intervention or series of interventions’ (World Health Organization 1998, p10.). Outcome measures allow us to evaluate whether such changes have occurred over time, and therefore play an important role in helping us deliver safe and effective interventions/services, which are valued by the people who access them.”
(Allied Health Professions (AHP) Outcome Measures UK Working Group, 2019).
As HCPC-registered healthcare professionals, occupational therapists are required to utilise outcome measures in their practice (Health and Care Professions Council, 2023). These measures are essential tools for evaluating the effectiveness of plans and interventions, benefiting both clients in receipt of and commissioners of services (Royal College of Occupational Therapists, 2021). While the impact of OT’s role is often easier to identify qualitatively—through people’s views during and following OT involvement—the quantitative data that can be measured either individually or across a wider cohort is often more challenging to measure and is sometimes neglected by the profession. At The OT Practice, we have sought to address this by enhancing our SMART goals and introducing an evidence based quantitative tool called the Patient-Specific Functional Scale (PSFS) into every assessment our OTs complete.
Before deciding on these measures to assess outcomes, we completed a thorough process of research to find the right outcome measure for our service. To start this process, we consulted the Guide to Selecting Outcome Measures: A Checklist for Allied Health Professionals (Allied Health Professions (AHP) Outcome Measures UK Working Group, 2019). This resource, created by a cross-disciplinary group representing several professional bodies for allied health professionals, guided our decision-making process and supported us in choosing the most suitable outcome measure for our practice.
Several options emerged, but ultimately, considering the wide range of clients our OTs see and how our independent therapists can use these tools, we chose the simplicity of the PSFS and the strengthening of the SMART goals writing process.
To inform and guide quality goal setting, all our therapists start their assessments by asking clients to define what they wish to accomplish through OT intervention. Our therapists then incorporate the wishes of the client into meaningful goals that are closely aligned with their daily life and needs. The involvement of family members or carers, when appropriate, further strengthens the relevance and support behind the goals.
The importance of SMART (Specific, Measurable, Achievable, Relevant, and Time-bound) Goals for Clear, Measurable Progress
We have always used SMART goals with our case management clients at The OT Practice. With recent improvements to our system’s functionality and an increased focus on supporting our therapists to enhance their goal-setting, we have strengthened this approach even further.
This change, combined with our therapists' expertise in incorporating client wishes into realistic goals, ensures that our clients' SMART goals truly reflect meaningful, client-centred goal setting.
The Patient-Specific Functional Scale (PSFS)
To provide a quantifiable rating for the SMART goals, now all our OTs use the Patient-Specific Functional Scale (PSFS) to assess clients' functional progress. The PSFS is a self-report outcome measure that utilises a scale from 0 (unable) to 10 (fully able) to perform a functional task. It enables clients to score their perceived ability to achieve their functional SMART goals. At the start of treatment, clients score their ability to perform activities related to their SMART goals. This score is updated throughout the treatment process, with a final score recorded at the end of treatment, reflecting the improvements made.
By using the PSFS to track client perceptions of their improvement alongside the therapist's expertise in treating the client, we can clearly quantify positive outcomes in achieving their functional goals. This demonstrates statistically significant results using a well-known, evidence based, respected tool that is valid, reliable, and responsive for assessing functional status in people.
How This Helps Case Managers
As case managers, we know that your role is integral in ensuring that your clients' therapy is effective, targeted, and results-driven. By using SMART goals and the PSFS, we believe that now our occupational therapists can help you track measurable progress and understand the specific outcomes your clients are working toward. This provides greater transparency on how your clients are progressing, making it easier for you to assess the success of interventions, communicate progress with clients and families. Also, by being better able to monitor the impact of our OT interventions this will make for more sustainable value for money and quality driven OT interventions.
Partners in client outcomes
At The OT Practice, we are committed to quality, and with the integration of SMART goals and PSFS scoring, we can now demonstrate the quality, effectiveness, and impact of our OTs interventions more clearly. We believe that our approach, in partnership with case managers, will significantly enhance outcomes and ensure that your client’s experience has a meaningful impact on their independence and wellbeing.
If you would like to learn more, please get in touch. We regularly attend Case Manager CPD meetings or lunch & learn events to present on specialist topics, and would welcome the opportunity to talk to your team in more detail about our outcome measures and PSFS scoring.
Request a copy of our Case Manager’s Handbook for in-depth details on the service we provide to Case Managers, including more ways to stay in touch. Call 0330 024 9910 or email debra@theotpractice.com.
References
Allied Health Professions (AHP) Outcome Measures UK Working Group (2019). Key questions to ask when selecting outcome measures: a checklist for allied health professionals. Available at: https://www.rcslt.org/wp-content/uploads/media/docs/selecting-outcome-measures.pdf (Accessed: 14 March 2025).
Health and Care Professions Council (2023). Standards of proficiency: Occupational therapists. Available at: https://www.hcpc-uk.org/standards/standards-of-proficiency/occupational-therapists/ (Accessed: 14 March 2025).
Royal College of Occupational Therapists (2021). Professional standards for occupational therapy practice, conduct and ethics. Available at: https://www.rcot.co.uk/publications/professional-standards-occupational-therapy-practice-conduct-and-ethics (Accessed: 14 March 2025).
