The use of routine outcome measures in two child and adolescent mental health services: a completed audit cycle

BMC Psychiatry

Chris Hollis²  Kapil Sayal²  John Taylor¹  Karen Newell¹  Michael Marriott⁴  Laurence Baldwin⁵  Maria Moldavsky⁴  Charlotte L Hall³ 

[1] CLAHRC, University of Nottingham, Nottingham, UK;Queens Medical Centre, University of Nottingham, Nottingham, UK;B07 Institute of Mental Health, University of Nottingham, Triumph Road, NG7 2TU Nottingham, UK;CAMHS, Nottinghamshire Healthcare NHS Trust, Nottinghamshire, UK;CAMHS, Derbyshire Healthcare NHS Foundation Trust, Derbyshire, UK

关键词: Audit;    Child and Adolescent Mental Health Services (CAMHS);    Routine Outcome Measurement (ROM);   

Others  :  1123924
DOI  :  10.1186/1471-244X-13-270

 received in 2013-04-22, accepted in 2013-10-10,  发布年份 2013

【 摘 要 】

Background

Routine outcome measurement (ROM) is important for assessing the clinical effectiveness of health services and for monitoring patient outcomes. Within Child and Adolescent Mental Health Services (CAMHS) in the UK the adoption of ROM in CAMHS has been supported by both national and local initiatives (such as government strategies, local commissioning policy, and research).

Methods

With the aim of assessing how these policies and initiatives may have influenced the uptake of ROM within two different CAMHS we report the findings of two case-note audits: a baseline audit conducted in January 2011 and a re-audit conducted two years later in December 2012-February 2013.

Results

The findings show an increase in both the single and repeated use of outcome measures from the time of the original audit, with repeated use (baseline and follow-up) of the Health of the Nation Outcome Scale for Children and Adolescents (HoNOSCA) scale increasing from 10% to 50% of cases. Re-audited case-notes contained more combined use of different outcome measures, with greater consensus on which measures to use. Outcome measures that were applicable across a wide range of clinical conditions were more likely to be used than symptom-specific measures, and measures that were completed by the clinician were found more often than measures completed by the service user.

Conclusions

The findings show a substantial improvement in the use of outcome measures within CAMHS. These increases in use were found across different service organisations which were subject to different types of local service priorities and drivers.

【 授权许可】

   
2013 Hall et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Department of Health: The NHS Outcome Framework 2011/12. London: The NHS Outcome Framework 2011/12; 2010.
• [2]Department of Health: National service framework for children, young people and maternity services: the mental health and psychological well-being of children and young people: standard - 9. In Development of methods to capture users’ views of child and adolescent mental health services in clinical governance reviews (Project evaluation report) Edited by DoH. 2007. http://www.corc.uk.net/wp…/CHI-evaluation-report-Attride-Stirling-J1.pdf webcite. Accessed 26 July 2012
• [3]Goodman R: The strengths and difficulties questionnaire: a research note. J Child Psychol Psychiatry 1997, 38:581-586.
• [4]Shaffer D, Gould MS, Brasic J, Ambrosini P, Fisher P, Bird H, Aluwahlia S: A childrens global assessment scale (CGAS). Arch Gen Psychiatry 1983, 40:1228-1231.
• [5]Gowers SG, Harrington RC, Whitton A, Lelliott P, Beevor A, Wing J, Jezzard R: Brief scale for measuring the outcomes of emotional and behavioural disorders in children - health of the nation outcome scales for children and adolescents (HoNOSCA). Br J Psychiatry 1999, 174:413-416.
• [6]Attride-Stirling J: Development of methods to capture users’ views of child and adolescent mental health services in clinical governance reviews (Project evaluation report). 2003.
• [7]Law D: Goal Based Outcomes(GBOs): Some useful information. Intenal CORC publication; 2011. Avaliable at http://www.corc.uk.net webcite
• [8]Chorpita BF, Yim L, Moffitt C, Umemoto LA, Francis SE: Assessment of symptoms of DSM-IV anxiety and depression in children: a revised child anxiety and depression scale. Behav Res Ther 2000, 38:835-855.
• [9]Miller SD, Duncan BL: The Outcome Rating Scale. Chicago, IL; 2000.
• [10]Johnson LD, Miller SD, Duncan BL: The Session Rating Scale 30. Chicago; 2000.
• [11]Johnston C, Gowers S: Routine outcome measurement: a survey of UK child and adolescent mental health services. Child Adolesc Mental Health 2005, 10:133-139.
• [12]Baruch G, Vrouva I: Collecting routine outcome data in a psychotherapy community clinic for young people: findings from an ongoing study. Child Adolesc Mental Health 2010, 15:30-36.
• [13]Batty M, Moldavsky M, Pass S, Foroushani PS, Marriot M, Sayal K, Hollis C: Implementing routine outcome measures in child and adolescent mental health services: from present to future practice. Child Adolesc Mental Healthdoi:10.1111/j.1475-3588.2012.00658.x
• [14]Hatfield DR, Ogles BM: The use of outcome measures by psychologists in clinical practice. Prof Psychol Res Pract 2004, 35:485-491.
• [15]Hatfield DR, Ogles B: Why some clinicians use outcome measures and others do not. Administration and Policy in Mental Health and Mental Health Service Research 2007, 34:283-291.
• [16]Close-Goedjen JL, Saunders SM: The effect of technical support on clinician attitudes toward an outcome assessment instrument. J Behav Heal Serv Res 2002, 29:99-108.
• [17]Willis A, Deane FP, Coombs T: Improving clinicians’ attitudes toward providing feedback on routine outcome assessments. Int J Ment Health Nurs 2009, 18:211-215.
• [18]Garralda E, Yates P: HoNOSCA: uses and limitations. Child Psychol Psychiatr Rev 2000, 5:131-132.
• [19]Bickman L: A measurement feedback system (MFS) is necessary to improve mental health outcomes. J Am Acad Child Adolesc Psychiatry 2008, 47:1114-1119.
• [20]Martin A-M, Fishman R, Baxter L, Ford T: Practitioners’ attitudes towards the use of standardized diagnostic assessment in routine practice: a qualitative study in two child and adolescent mental health services. Clin Child Psychol Psychiatry 2011, 16:407-420.
• [21]Conners C: Rating scales for use in drug studies with children. Psychopharmacology Bulletin [special issue on children] 1973, 9:24-42.
• [22]Gowers S, Levine W, Bailey-Rogers S, Shore A, Burhouse E: Use of a rotuine, self-report outcome measure (HoNOSCA-SR) in two adolescent mental health servies. Br J Psychiatry 2002, 180:266-269.
• [23]Garland AF, Kruse M, Aarons GA: Clinicians and outcome measurement: what’s the use? J Behav Health Serv Res 2003, 30:393-405.
• [24]Goodman R: Psychometric properties of the strengths and difficulties questionnaire. J Am Acad Child Adolesc Psychiatry 2001, 40:1337-1345.
• [25]Goodman R, Scott S: Comparing the strengths and difficulties questionnaire and the child behavior checklist: is small beautiful? J Abnorm Child Psychol 1999, 27:17-24.
• [26]Goodman R: The extended version of the strengths and difficulties questionnaire as a guide to child psychiatric caseness and consequent burden. J Child Psychol Psychiatry 1999, 40:791-799.
• [27]Barkham M, Margison F, Leach C, Lucock M, Mellor-Clark J, Evans C, Benson L, Connell J, Audin K, McGrath G: Service profiling and outcomes benchmarking using the CORE-OM: toward practice-based evidence in the psychological therapies. J Consult Clin Psychol 2001, 69:184-196.
• [28]Ford T, Tingay T, Wolpert M, Group CS: CORC’s Survey of routine outcome monitoring and national CAMHS dataset developments: a response to johnston and gower. Child Adolesc Mental Health 2006, 11:50-52.
• [29]Oates J: Building regional health care networks in Europe. Amsterdam: Ios PressInc; 2000.
• [30]Kiger LS, Kiger LS: Content and structure of health record. In Health Information Management: Principles and organization for health information services. Edited by Skurka M. Chicago: Jossey-Bass; 2003:19-44.
• [31]Garralda EM: Accountability of specialist child and adolescent mental health services. Br J Psychiatry 2009, 194:389-391.
• [32]Hanssen-Bauer K, Gowers S, Aalen OO, Bilenberg N, Brann P, Garralda E, Merry S, Heyerdahl S: Cross-national reliability of clinician-rated outcome measures in child and adolescent mental health services. Adm Policy Ment Health Ment Health Serv 2007, 34:513-518.
• [33]American Psychiatric Association: Diagnostic and statistical manual of mental disorders. Arlington, VA: American Psychiatric Publishing; 2013.
• [34]Garralda EM, Yates P, Higginson I: Child and adolescent mental health service use – HoNOSCA as an outcome meaure. Br J Psychiatry 2000, 177:52-58.
• [35]Truman J, Robinson K, Evans AL, Smith D, Cunningham L, Millward R, Minnis H: The strengths and difficulties questionnaire - a pilot study of a new computer version of the self-report scale. Eur Child Adolesc Psychiatry 2003, 12:9-14.
• [36]Timimi S, Tetley D, Burgoine W, Walker G: Outcome orientated child and adolescent mental health services (OO-CAMHS): a whole service model. Clin Child Psychol Psychiatry 2012, 17:1-16.