Measuring What Matters: Redesigning Evaluation With Consumers to Understand Engagement in Hand Therapy Using Virtual Reality.

INTRODUCTION: Consumer involvement is essential to ensure health service evaluations reflect what matters to those receiving care. This service improvement project describes how the evaluation of virtual reality (VR) in outpatient hand therapy was redesigned in partnership with consumers to better capture engagement with hand therapy. METHOD: The evaluation was undertaken in an outpatient hand therapy service. Initial evaluation relied on standardised quantitative measures, which did not address the original purpose of implementing VR in the treatment setting. Through collaboration with consumer partners and research mentors, the evaluation was redesigned using a value-based care framework (comfort, capability and calm). Questionnaires using open and closed questions were developed in partnership with consumers and administered to both consumers attending the hand therapy unit and clinicians who worked in the unit. RESULTS: Seven clinicians and 12 consumers participated. The redesigned evaluation identified that VR enhanced engagement with therapy by creating a low-pressure and engaging environment. These findings would not have been captured in the original evaluation approach. Participants identified contextual factors (physical space, technology reliability, cultural and language considerations, and the importance of 'hands-on' guidance) that influenced the successful use of VR. CONCLUSIONS: Co-designing the evaluation of the service improvement project fundamentally changed what was measured and understood. This study demonstrates that involving consumers in how we evaluate projects can provide insights about engagement in therapeutic intervention. Partnering with consumers shaped this project and ensured outcomes reflected real-world needs. This approach is encouraged across future hand therapy projects and research to ensure that innovation in clinical practice truly aligns with the people they are designed to support.