Benchmarking outcomes in dysphasia using the Therapy Outcome Measure

Background: Quality improvement in health care seeks to drive equitable, effective, and appropriate services. Benchmarking can be used as a tool for acquiring clinical information to inform and monitor change in order to identify commonalities and significant differences. Aims: This study reports on a benchmarking study of eight speech and language therapy services providing interventions for persons with dysphasia, addressing three questions related to equity of access to treatment; changes associated with treatment; and profiles on discharge. Methods & Procedures: The Therapy Outcome Measure (TOM) (Enderby & John, 1997) was used as the indicator. The SLTs were trained and inter-rater reliability checked. Data were collected on consecutively referred cases on entry to treatment and on discharge. Outcomes & Results: No difference was found in the profiles of patients referred to the different services on entry to treatment. While a significant difference was found between the services in the number of cases changing in impairment and disability/activity, the final outcomes reported were similar on discharge on impairment, disability/activity, and participation, but showed significant statistical difference on well-being. The number of contacts and duration of treatment varied across the services, even on cases with mild impairment. Conclusions: The results indicated equity of access, a difference in the effects of treatment on the different dimensions, and a significant difference on the dimension of well-being at discharge. Each service was able to compare their outcomes with those of the other services, observe the variations, and exchange information with those services in order to the identify reasons for the results.