OT FACT - R2D2 Center at UW-Milwaukee

OT FACT: Dual Purpose Design - R2D2 Center at UW-Milwaukee

Dual Purpose Design

A primary concept of OT FACT design is that there are two competing purposes for performing functional assessment.

Obtaining performance outcome measures.
Diagnosing an individual's functional deficits.

The difference between the two is critical to understand. An outcome measure is derived by administrators, accrediting agencies, quality review organizations, researchers, and funding agencies for program evaluation, quality assurance activities, research data collection, documentation of impact of therapy, quantification of need, etc. For these purposes, it is necessary to have valid and reliable outcome measures that are aggregate quantified figures; that is, one or a few numbers which summarize a person's function.

On the other hand, therapists need to identify and track an individual's functional deficits for organizing and implementing an appropriate treatment for optimizing function. For this purpose, summary functional performance information isn't as helpful. Therapists need more detail to highlight the specific areas of functional deficit and to relate areas of deficit to higher levels of functional outcome. For example, not only does a therapist need to know whether an individual has a problem with independently dressing, but the therapist also needs to know why there is a problem. Is it a hand function deficit due to weakness? Is it because they select clothing inappropriate for the weather? An outcome measure quantifies the degree of the dressing problem. A diagnostic system helps explain why. An outcome measure summaries the amount of a functional problem. A diagnostic system leads to the formulation of treatment and intervention plans.

During the development of OT FACT, the design team refused to choose an outcome or diagnostic focus. The belief that a dual purpose system could be designed, combined with a theoretical base and innovative design techniques, led to the creation of a system which performs both outcome and diagnostic functions.

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