In one of my previous newsletters on reasons why clinicians aren’t tracking outcomes, I unpacked the very real barriers we face, from lack of funding, to clients disengaging. We know why we aren't doing it. But let’s face it, knowing the barriers doesn't solve the problem.

With the massive changes happening in the NDIS and other funding schemes, crunch time is officially here. Funders don't just want our "gut feeling" that a client is improving; they want quantifiable proof of change over time, and if we don't provide it, our clients are at high risk of losing their funding.

So, how do we move from "too-hard basket" to outcome measurement being a routine part of our practice? Here are the 5 things you should start with to successfully track and measure outcomes in your daily practice.

1. Get your clients on board from day one

Before you measure anything, you and your client need to be on the same page. Let’s be honest: tracking outcomes often involves them having to do a bit of extra work, like keeping logs or filling out surveys. If they don’t understand why, it just feels like we’re dumping unnecessary homework on them, or using their funding on things that are "nice to have" rather than an essential part of the clinical process.

Try this: Start planting the seed early. Use your pre-appointment information packages or your very first session to explain how you work. Explicitly state that goal setting and evaluation are built-in steps of your service. Speak their language with explanations that matter to them – it’s not just about us wanting to be able to measure our work; it’s also important for them because funding bodies (like the NDIA) expect us to show this data to protect their ongoing funding. It also might mean managing their expectations by explaining that you’ll focus deeply on one or two priority goals first to get measurable results, rather than scratching the surface of ten different things at once.

2. Get yourself on board (and map your workflow)

Yes, we need to get clients onboard with outcome measurement, but we need to make sure we believe in the power of measuring outcomes ourselves first! It's easy for clinicians to slip into autopilot, especially when we are swamped and follow-up is poorly funded. We start to assume follow-up isn't possible, so we just cross it off our mental list. We also can still remember the uni lectures focused on goal setting and measuring baseline function, but when we’re under pressure to just get in and get things done, these things seem like a luxury. But we need a conscious stop and reset.

Try this: Go back to a solid OT process and map out your actual clinical workflow. Whether you use the Canadian Practice Process Framework or your own step-by-step method, write down exactly where goal setting, baseline measuring, and formal evaluation fit in. Create a physical workflow document and stick it somewhere where you’ll see it. This keeps outcome measurement front of mind for you, and it could also be adapted to serve as a fantastic visual resource to share with families. When they see that evaluation is a non-negotiable step on your roadmap, they’ll expect it too.

3. Put function and participation at the centre of your goals

To measure an outcome, you must have a clear, measurable goal. Funders do not care about fine motor dexterity or muscle grades unless you tell them how it impacts the client's daily life. Your goals must keep function and participation at the very centre.

Try this: Take those big, broad goals (like "improving independence with domestic skills") and bring them down to something highly specific. Goal Attainment Scaling (GAS) or the Canadian Occupational Performance Measure (COPM) are gold standards that allow you to be activity focused and specific enough that the goal itself becomes a measurement tool. But remember: GAS and COPM have subjective elements; they rely on client satisfaction or our clinical estimates. To make your reports watertight, always aim to combine these with objective functional measures (more on this in the next section).

4. Collect baseline data (before you do anything else!)

There is absolutely no point in working with a client for 12 months and then frantically asking, "How do I prove they improved?" if you have zero baseline data to compare it to. You must capture the "before" to show the "after".

Try this: Before starting your therapy block, select your measures with purpose. If standardised tools like the Modified Barthel Index, FIM, or Life Skills Profile are suitable for your client, and you’re expecting their scores on these tools would change in a meaningful way if they were to achieve their goals, then you can start here.

If a standardised tool doesn’t fit or isn't sensitive enough, go non-standardised. Design a simple log to track the numbers: how long does a morning routine take? How many verbal prompts are required? How many times is a carer woken up overnight? Showing a funder that the need for overnight assistance dropped from 3 hours to 1 hour, and now funding for passive supports rather than active overnight supports is appropriate, is the exact kind of cost-saving data that will help prove the value allied health clinicians can offer.

5. Remember to go back and actually collect the data

Baseline data is completely useless if you never go back to repeat the measurement. Make sure you go back to that beautiful new workflow document you now have to remind you when you should be doing this re-measure. But remember, you don’t need to just wait until the end of a 12-month plan to check-in; regular check-ins throughout your therapy program will allow you to judge whether or not your strategies are working, and if they aren’t, you’ll realise that while there is still time and funding left to pivot to something new.

Try this: Set regular touchpoints throughout your therapy block to monitor progress. For some clients, regular check-ins build motivation and engagement, while for others it is extra work, so be intentional about how you are doing these mid-point reviews. Once you are routinely collecting outcome data for individual clients, you’ll be in a much better place to collate that information on a larger scale to determine which of your services are having the most impact, and which parts could benefit from a review. This collective data is powerful; it builds your clinical confidence, and it gives us the stats we need for systemic advocacy to prove the financial and functional impact occupational therapists can offer.

My final thoughts…

Measuring outcomes can feel like just another administrative hurdle, but it is actually the core of good OT practice. It’s how we protect our clients' funding, build our own clinical competence, and show the world what we’re worth. Choose just one of these steps to implement in your practice this week. You don't have to overhaul your whole system overnight, just start!

If you found this blog helpful, check out the Your OT Tutor website and subscribe to the mailing list or sign-up for the Learning Library – there are heaps of resources, courses, and CPD opportunities, with more being added regularly. You can also subscribe to the "How to be a better OT" podcast to hear more from me on your favourite streaming platform.