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01.12.2012 | Research article | Ausgabe 1/2012 Open Access

BMC Health Services Research 1/2012

The barriers and facilitators to routine outcome measurement by allied health professionals in practice: a systematic review

BMC Health Services Research > Ausgabe 1/2012
Edward AS Duncan, Jennifer Murray
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1472-6963-12-96) contains supplementary material, which is available to authorized users.

Competing interests

This study was funded by a grant from the Scottish Government Health and Social Care Directorates. The funder did not have any involvement in the planning, execution, drafting or writing of the manuscript.

Authors’ contributions

ED conceived of the review and led the development of the study protocol. JM conducted the literature search and data extraction. ED and JM undertook quality appraisal, analysis and synthesis. JM produced the initial draft manuscript. ED critically revised the manuscript for important intellectual content. ED and JM produced the final review. Both authors read and approved the final manuscript.



Allied Health Professionals today are required, more than ever before, to demonstrate their impact. However, despite at least 20 years of expectation, many services fail to deliver routine outcome measurement in practice. This systematic review investigates what helps and hinders routine outcome measurement of allied health professionals practice.


A systematic review protocol was developed comprising: a defined search strategy for PsycINFO, MEDLINE and CINHAL databases and inclusion criteria and systematic procedures for data extraction and quality appraisal. Studies were included if they were published in English and investigated facilitators and/or barriers to routine outcome measurement by allied health professionals. No restrictions were placed on publication type, design, country, or year of publication. Reference lists of included publications were searched to identify additional papers. Descriptive methods were used to synthesise the findings.


960 papers were retrieved; 15 met the inclusion criteria. Professional groups represented were Physiotherapy, Occupational Therapy, and Speech and Language Therapy. The included literature varied in quality and design. Facilitators and barriers to routine outcome measurement exist at individual, managerial and organisational levels. Key factors affecting professionals’ use of routine outcome measurement include: professionals’ level of knowledge and confidence about using outcome measures, and the degree of organisational and peer-support professionals received with a view to promoting their work in practice.


Whilst the importance of routinely measuring outcomes within the allied health professions is well recognised, it has largely failed to be delivered in practice. Factors that influence clinicians’ ability and desire to undertake routine outcome measurement are bi-directional: they can act as either facilitators or barriers. Routine outcome measurement may only be deliverable if appropriate action is taken at individual therapist, team, and organisational levels of an organisation.
Additional file 1: Search strategy terms. The search terms used in each of the databases searched in the current review, and the number of articles returned at each stage. (DOC 31 KB)
Additional file 2: List of studies excluded from the review following full paper appraisal stage (N = 42). A table containing the studies excluded from the current review following full paper appraisal. (DOC 58 KB)
Additional file 3: Summary of quality appraisal information for included studies. A table containing the quality appraisal and study details for the 15 papers included in the current review. (DOC 47 KB)
Authors’ original file for figure 1
Authors’ original file for figure 2
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