Quality of local authority occupational therapy services: developing an instrument to measure the user's perspective.

The aims of this paper are threefold: (1) to describe the development of an instrument measuring quality of care from the specific perspective of the users of local authority occupational therapy services; (2) to present the results from a survey of users' views about the quality of services offered by a county-wide local authority occupational therapy service compared with other health and social care services; and (3) to examine the potential of the instrument to form part of a more general process of quality assurance and quality improvement within local authority occupational therapy services. A combination of qualitative and quantitative methods was used. Focus group discussions with users preceded a postal survey. Questionnaires were sent to a random sample of 997 disabled people living in Kent who were users of the local authority Occupational Therapy Bureau. The response rate was 55%. An instrument was developed (QUOTE-OT) which was tailored to the expressed needs of the users of a local authority occupational therapy service (Kent Occupational Therapy Bureau). On the basis of this new instrument, the Kent Occupational Therapy Bureau received relatively high performance scores on the quality of care dimensions that were the most important for users, such as aspects that referred to courtesy and the level of professional competence. On the other hand, room for improvement existed on aspects such as the accessibility of occupational therapy services, information given to users and follow-up services. The evidence suggests that the QUOTE-OT questionnaire for assessing users' views of quality of care could be an appropriate tool for evaluating and monitoring local authority occupational therapy service quality. (aut. ref.)