Routine outcome measurement in public mental health: results of a clinician survey

This paper explores the attitudes of mental health workers in one public mental health service towards the implementation and use of routine outcome measurement. Two years after their introduction into routine clinical practice, there were equal numbers of positive and negative observations from clinicians about the clinical value of the clinician-rated outcome measures, while more positive observations were made about value of the consumer-rated outcome measure. The most frequent observation from clinicians in relation to making outcome measures more useful to them in clinical practice was that more training, particularly refresher training, is needed. In addition, clinicians indicated that more sophisticated support which assists them to understand the meaning and possible use of outcome measure ratings is required.

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Measuring what matters to patients: Using goal content to inform measure choice and development

Clinical Child Psychology and Psychiatry ◽

10.1177/1359104515615642 ◽

2015 ◽

Vol 22 (2) ◽

pp. 170-186 ◽

Cited By ~ 13

Author(s):

Jenna Jacob ◽

Julian Edbrooke-Childs ◽

Duncan Law ◽

Miranda Wolpert

Keyword(s):

Mental Health ◽

Young People ◽

Health Services ◽

Outcome Measures ◽

Outcome Measure ◽

Outcome Measurement ◽

Comparison Method ◽

Future Planning ◽

Children And Young People ◽

Relevant Outcome

Introduction: Personalised care requires personalised outcomes and ways of feeding back clinically useful information to clinicians and practitioners, but it is not clear how to best personalise outcome measurement and feedback using existing standardised outcome measures. Method: The constant comparison method of grounded theory was used to compare goal themes derived from goals set at the outset of therapy for 180 children aged between 4 and 17 years, visiting eight child and adolescent mental health services, to existing standardised outcome measures used as part of common national datasets. Results: In all, 20 out of 27 goal themes corresponded to items on at least one commonly used outcome measure. Discussion: Consideration of goal themes helped to identify potential relevant outcome measures. However, there were several goal themes that were not captured by items on standardised outcome measures. These seemed to be related to existential factors such as understanding, thinking about oneself and future planning. Conclusion: This presents a powerful framework for how clinicians can use goals to help select a standardised outcome measure (where this is helpful) in addition to the use of a goal-based outcome measure and personalise choices. There may be areas not captured by standardised outcome measures that may be important for children and young people and which may only be currently captured in goal measurement. There is an indication that we may not be measuring what is important to children and young people. We may need to develop or look for new measures that capture these areas.

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It's not that bad: the views of consumers and carers about routine outcome measurement in mental health

Australian Health Review ◽

10.1071/ah090093 ◽

2009 ◽

Vol 33 (1) ◽

pp. 93 ◽

Cited By ~ 12

Author(s):

Jennifer Black ◽

Tania Lewis ◽

Pamela McIntosh ◽

Tom Callaly ◽

Tim Coombs ◽

...

Keyword(s):

Mental Health ◽

Clinical Practice ◽

Outcome Measurement ◽

Clinical Use ◽

Self Assessment ◽

Routine Outcome Measurement ◽

The Past ◽

Assessment Measure ◽

Promotional Materials ◽

Mandatory Use

The mandatory use of routine outcome measurement (ROM) has been introduced into all public sector mental health services in Australia over the past 6 years. Qualitative processes were used to engage consumers and carers in suggesting how the measures can be used in clinical practice. The project involved an audit by survey, followed by a range of interactive workshops designed to elicit the views of consumers, carers and clinicians, as well as to involve all parties in dialogue about ROM. In addition, there was engagement of consumers and carers in the training of clinicians in the clinical use of ROM, and in the production of promotional materials aimed at informing consumers and carers about ROM. When consumers and carers have had an opportunity to be involved in ROM they have found it a useful experience, and those who had not been involved can see the potential. Consumers and carers indicated that they believe the greatest opportunity arising from the suite of measures is the use of the consumer self-assessment measure the Behaviour and Symptom Identification Scale (BASIS-32).

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Use of a routine, self-report outcome measure (HoNOSCA–SR) in two adolescent mental health services

The British Journal of Psychiatry ◽

10.1192/bjp.180.3.266 ◽

2002 ◽

Vol 180 (3) ◽

pp. 266-269 ◽

Cited By ~ 44

Author(s):

Simon Gowers ◽

Warren Levine ◽

Sarah Bailey-Rogers ◽

Alison Shore ◽

Emma Burhouse

Keyword(s):

Mental Health ◽

Outcome Measure ◽

Outcome Measurement ◽

Reliability And Validity ◽

Adolescent Mental Health ◽

Self Report ◽

Routine Outcome Measurement ◽

Health Measures ◽

Length Of Treatment ◽

Report Outcome Measure

BackgroundThe Health of the Nation Outcome Scale for Children and Adolescents (HoNOSCA) is an established outcome measure for child and adolescent mental health. Little is known of adolescent views on outcome.AimsTo develop and test the properties of an adolescent, self-rated version of the scale (HoNOSCA–SR) against the established clinician-rated version.MethodA comparison was made of 6-weekly clinician-rated and self-rated assessments of adolescents attending two services, using HoNOSCA and other mental health measures.ResultsAdolescents found HoNOSCA–SR acceptable and easy to rate. They rated fewer difficulties than the clinicians and these difficulties were felt to improve less during treatment, although this varied with diagnosis and length of treatment. Although HoNOSCA–SR showed satisfactory reliability and validity, agreement between clinicians and users in individual cases was poor.ConclusionsRoutine outcome measurement can include adolescent self-rating with modest additional resources. The discrepancy between staff and adolescent views requires further evaluation.

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Routine outcome measurement in public mental health — what do clinicians think?

Australian Health Review ◽

10.1071/ah060144 ◽

2006 ◽

Vol 30 (2) ◽

pp. 144 ◽

Cited By ~ 18

Author(s):

Tom Trauer ◽

Lisa Gill ◽

Glenda Pedwell ◽

Peta Slattery

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Health Services ◽

Outcome Measurement ◽

Public Mental Health ◽

Good Information ◽

Routine Outcome Measurement ◽

Real Progress ◽

Made In

IN ORDER TO FULLY EVALUATE and manage a service, one should be able to answer all parts of the question ?Who receives what services, from whom, at what cost, and with what effect??1 While there is good information on the first four elements, mental health services generally do less well in demonstrating the effectiveness of what they do, and it is here that routine outcome measurement (ROM) can make a contribution. Despite the very real progress that has been made in implementing ROM in Australia it is evident from a variety of sources, formal and informal, that not everyone is convinced of its necessity or value.

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Outcome measurement in Australian non-government organisations: a descriptive study of recovery-based mental health workers’ experiences and beliefs

Advances in Mental Health ◽

10.1080/18387357.2018.1493346 ◽

2018 ◽

Vol 17 (2) ◽

pp. 98-109 ◽

Cited By ~ 1

Author(s):

Josephine Logan ◽

Amanda Wheeler

Keyword(s):

Mental Health ◽

Health Workers ◽

Outcome Measurement ◽

Descriptive Study ◽

Mental Health Workers

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A systematic review of patient-reported outcome measurement (PROM) and provider assessment in mental health: goals, implementation, setting, measurement characteristics and barriers

International Journal for Quality in Health Care ◽

10.1093/intqhc/mzz133 ◽

2020 ◽

Author(s):

Marc Gelkopf ◽

Yael Mazor ◽

David Roe

Keyword(s):

Mental Health ◽

Clinical Practice ◽

Outcome Measures ◽

Outcome Measurement ◽

Web Security ◽

Patient Reported Outcome ◽

Self Report ◽

Attrition Rate ◽

Review Of Literature ◽

Patient Reported

Abstract Purpose To review and integrate the literature on mental-health-related patient-reported outcome measures (PROMs) and routine outcome measures (ROMs), namely in the domains of goals, characteristics, implementation, settings, measurements and barriers. PROM/ROM aims mainly to ascertain treatment impact in routine clinical practice through systematic service users’ health assessment using standardized self-report, caretaker and/or provider assessment. Data sources Psych INFO and PubMed including Medline, Biomed Central, EMBASE Psychiatry and Elsevier Science’s Direct. Study selection Systemized review of literature (2000–2018) on implementation and sustainability of PROMs/ROMs in adult mental health settings (MHS). Data extraction and synthesis Systemized review of literature (2000–2018) on numerous aspects of PROM/ROM implementation and sustainability in adult MHS worldwide. Results Based on 103 articles, PROMs/ROMs were implemented mostly in outpatient settings for people with assorted mental health disorders receiving a diversity of services. Frequency of assessments and completion rates varied: one-third of projects had provider assessments; about half had both provider and self-assessments. Barriers to implementation: perceptions that PROM/ROM is intrusive to clinical practice, lack of infrastructure, fear that results may be used for cost containment and service eligibility instead of service quality improvement, difficulties with measures, ethical and confidentiality regulations and web security data management regulations. Conclusion Improving data input systems, sufficient training, regular feedback, measures to increase administrative and logistic support to improve implementation, acceptability, feasibility and sustainability, follow-up assessments and client attrition rate reduction efforts are only some measures needed to enhance PROM/ROM efficiency and efficacy.

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Views of general public, mental health professionals and patients’ relatives about schizophrenia: An Italian multi-centric survey

European Psychiatry ◽

10.1016/s0924-9338(11)72239-8 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 532-532

Author(s):

A. Fiorillo ◽

C. De Rosa ◽

C. Malangone ◽

M. Luciano ◽

D. Giacco ◽

...

Keyword(s):

Mental Health ◽

Civil Rights ◽

Mental Health Professionals ◽

Health Professionals ◽

General Public ◽

Health Workers ◽

Public Mental Health ◽

Target Population ◽

Mental Health Workers ◽

Italian Population

IntroductionViews on the causes and psychosocial consequences of schizophrenia of the Italian population, patients’ relatives and mental health professionals can influence detection and outcome of these disorders.AimsTo investigate the opinions on schizophrenia in a sample of 614 lay respondents, 465 mental health professionals and 709 key-relatives.MethodsThe survey was conducted in 30 randomly selected geographical areas with the Questionnaire about Opinions on mental illness (QO).ResultsThe results show significant differences among the three groups as regards opinions about patients’ civil rights and social competence of patients with schizophrenia. In particular, the belief that patients’ behaviors are unpredictable is maintained by 18% of mental health workers and by 35% of family members and the general public. As regards causes, 68% of relatives, 20% of mental health workers and 34% of general public believe that schizophrenia is caused by psychosocial factors only. Forty-eight percent of the relatives affirmed that they are fully convinced of the usefulness of pharmacological treatment compared to 28% of professionals and 25% of the Italian population. With respect to civil rights, about half of the relatives is fully convinced that patients with schizophrenia should not have children compared to 17% of mental health workers and to 19% of the general public.ConclusionsThese results underline the need to conduct sensitization campaigns about schizophrenia focused on specific aspects of the disease, such as unpredictability, civil rights and opportunities to recovery of patients, taking into account the target population to which they are addressed.

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The DASH (Disabilities of the Arm, Shoulder and Hand) Outcome Measure: What do we know about it now?

The British Journal of Hand Therapy ◽

10.1177/175899830100600401 ◽

2001 ◽

Vol 6 (4) ◽

pp. 109-118 ◽

Cited By ~ 119

Author(s):

Dorcas E Beaton ◽

Aileen M Davis ◽

Pamela Hudak ◽

Sara Mcconnell

Keyword(s):

Clinical Practice ◽

Physical Function ◽

Outcome Measures ◽

Musculoskeletal System ◽

Outcome Measure ◽

Outcome Measurement ◽

Future Research ◽

Strength Testing ◽

Joint Motion ◽

The Impact

Outcome measurement is an essential component for defining the effectiveness of clinicians’ practice (Reiman 1988) and standardised measures make that job more consistent, comparable and valid (Cole et al 1994). Hand therapists have long recognised the need for the standardisation of outcome measures, particularly for performance-based measures such as strength testing (Mathiowetz et al 1985, Woody et al 1988) or joint motion. More recently there has been an increased interest in outcome measures that capture the patient's perspective of their status, and that are standardised. The DASH (Disabilities of the Arm, Shoulder and Hand) is a standardised outcome measure that could be used for this purpose (Hudak et al 1996, McConnell et al 1999). The DASH reflects the impact of a disorder in terms of physical function and symptoms, which are the two main reasons patients seek care for a disorder of the musculoskeletal system. The DASH is becoming widely used by clinicians and researchers (McConnell et al 1999). It is now important to revisit what we know about how well the DASH is able to measure what it purports to measure. The purpose of this paper is to review the research that has been done to date on the DASH outcome measure, and to describe the implications of this for future research and for clinical practice.

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