Goal attainment scaling within a community-based multidisciplinary neurorehabilitation service: behaviour change and knowledge translation

Ms Kate Phillips1, Ms Amy Jesse1, Ms Nicole  Caplan1

1Independent Rehabilitation Services, Ashburton, Australia

The OT team (within Independent Rehabilitation Services), identified that there was inconsistent use of outcome measures. A literature review determined the Goal Attainment Scale (GAS) an appropriate outcome measure to use with our clients.

Aims:

  • OT team to consistently complete GAS for all appropriate clients.
  • Increase OTs’ confidence completing GAS goals.

Method:

At baseline, eight OTs completed a confidence rating survey using GAS. 10 client files were reviewed per OT to audit the frequency of GAS use.  Following baseline; skills training commenced, with development of a GAS database for recording examples in a range of occupational performance areas; a process flow chart to improve consistency and a justification form to document if the GAS was not appropriate.

File audits were completed post skills training and after a further 6 months. The confidence survey was readministered following the training period.

Results:

The use of GAS increased by 56.5% from baseline to post skills training and an additional increase of 22% post skills training to follow up. The self-rated confidence scores increased by an average of 2.49 points out of ten from baseline to post skills training and a further 1.63 points from post skills training to follow up.

There was a significant increase in overall completion of the GAS and the confidence levels of OTs. This demonstrates that skills training, supported the occupational therapy team to translate evidence based practice into effective standard practice.