Background:

Occupational therapists are increasingly asked to demonstrate the effectiveness, appropriateness, and efficiency of their interventions to funding bodies. The aim of this scoping review was to establish which quality indicators are used internationally to demonstrate the effectiveness, appropriateness, and/ or efficiency of occupational therapy interventions to funding bodies.

Method:  

To achieve the aim of this study, we conducted a scoping review. We limited 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 several national occupational therapy associations and other international contacts of the EVS/ASE to ask for access to documents found within this search that were only accessible to association members.

Results:

The screening process resulted in 32 studies and documents from six national contexts. We identified and described process-level indicators, functional outcome indicators, an outcome indicator based on individual goal attainment, the goal attainment scale (GAS,) and PRO-Ergo, a patient reported experience measure (PREM).

Findings:

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 the 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:

All identified quality indicators have their 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 participation and activity. Functional outcome indicators that cover a broad area of client problems may be useful additional quality indicators for some areas of practice.