Perceptions of improving quality and quality measurement in occupational therapy: a global survey

Resumen

Introduction: A guiding principle for the occupational therapy profession is the use of best available evidence to ensure the provision of quality services. Many organisations collect quality indicator data to monitor and improve service performance. Objectives: To understand the perspectives of occupational therapists regarding the quality of services provided, investigate quality measurement practices, particularly with the Quality Evaluation Strategy Tool (QUEST), and explore how measurement data is used. Method: The World Federation of Occupational Therapists (WFOT) circulated an online survey in four languages to the global occupational therapy community in 2025. Data were analysed descriptively and stratified by country income, language, indicator use and familiarity with QUEST. Chi Square analysis was used to determine statistical significance of differences among subgroups. Results: Complete survey responses were received from 518 participants representing 61 countries. Lowest mean quality scores related to waiting times (2.93/5) and the availability of occupational therapists (2.96/5). Indicators were used by 53.1% of respondents, with more indicator users among high income countries and English respondents (p<.001). Although only 16% of respondents were familiar with QUEST, QUEST users were more confident in utilising indicators (p><.001) and reported a greater use of indicators for evaluating service changes (p><.001) and use of best available evidence (p><.001). Conclusion: Effective action to improve quality of service performance requires data to fully understand the nature of variations, identify evidence-based solutions and evaluate success of improvements. It is therefore imperative that the use of quality measures such as QUEST indicators becomes more widespread in occupational therapy.