Development and Evaluation of a Neurorehabilitation Outcomes Database
Research type
Research Study
Full title
The Measurement of neuro-rehabilitation, patient-centred Outcomes Development and Formative Process Evaluation Project - MODE
IRAS ID
172536
Contact name
Carina Hibberd
Contact email
Sponsor organisation
University of Stirling
Duration of Study in the UK
1 years, 2 months, 31 days
Research summary
Rehabilitation of patients is a crucial component of effective healthcare delivery, particularly within a context of an aging population and associated multi-morbidities (Duncan & Murray, 2012a) (The Scottish Government, 2010b) (Sigerson & Gruer, 2011) (Government, 2012) (The Scottish Government, 2010a). Given the impact that rehabilitation can have on people’s lives, and the scale of rehabilitation services being delivered, it is essential that the interventions being delivered are appropriately evaluated. Patient-reported outcome measurements should enable the impact of rehabilitation on patients’ lives to be monitored and maintained (Measures & Group, 2011), which in turn could inform future service provision (The Scottish Government, 2010b). This is essential to achieve and maintain effective, safe and person-centred care in accordance with Scottish Government’s quality strategy.
To ensure such high quality evaluation and monitoring key outcomes to be monitored must be decided upon. These must be meaningful and important to both service users and the multi-disciplinary team, valid, reliable, sensitive to change and useful to inform practice. However, the reality is that selecting which area of rehabilitation to evaluate, and which outcome measures to use to achieve this is challenging and can act as a barrier to routine outcome measurement in practice (Duncan & Murray, 2012a).
NHS Fife Rehabilitation Service has been working with the Nursing, Midwives and Allied Health Professionals Research Unit (NMAHP-RU) to develop a pilot Neurological Rehabilitation Outcomes Management System (NROMS) which will: be evidence-based; be person centred; be practical to use; facilitate patient, clinical service and business management; monitor patients throughout their patient journey. With these aims in mind, the development to date has taken a co-production approach. Decisions about what needs to be measured have been reached by clinical members of the steering committee, based upon clinical judgement and consensus exercises conducted with service users, stakeholders and rehabilitation clinical staff (conducted by the NMAHP-RU). Potential measures which mapped against these measurement targets were identified with systemised review conducted by the NMAHP-RU team and decisions made by the clinical team. A pilot NROMS system has been developed by the NHS eHealth system. The final core system should form a minimum dataset which can be augmented in each clinical area and potentially used by other services in Scotland.
The current mixed-methods implementation study plans to further develop the NROMS pilot by iteratively implementing in wards involved in the neuro-rehabilitation service, with staff feedback (observation and interviews) and system adaptation. The system will then be run for approximately 8 months and evaluated through staff feedback, audit of anonymised patient data and the development of pilot reports for NHS management. The study will explore system, team and contextual issues in the development and implementation of a patient centred data system in the NHS.
REC name
North East - Tyne & Wear South Research Ethics Committee
REC reference
15/NE/0200
Date of REC Opinion
11 Jun 2015
REC opinion
Favourable Opinion