Outcomes from a short-term loan library: Challenges for clinical practice

The Communication, Learning and Technology (CLT) Service at Great Ormond Street Hospital, London, offers specialist advice to children (80-100 per year) with communication needs. Trial of equipment forms part of the pathway of care which aims to establish successful communication systems for children. Assessment findings determine a “short-list” of trial equipment, which is loaned to children for 6-12 weeks. Evaluation of the impact of equipment then forms the basis of recommendations for purchase and support.
Appraising the outcomes of these loans has proven challenging: measures relevant to identifying the success of communication systems are much debated. Valuable measures in the long-term based on increased participation, quality of life, or academic achievement may be of little use as indicators of potential benefit during a short-term trial. Evaluation of the impact of loaned equipment needs assessment of potential value since the full impact of the equipment may not be apparent.