Routine outcome measurement in Australia

Abstract

Australia has been implementing routine outcome measurement in its specialized public sector mental health services for over a decade. It uses a range of clinician-rated and consumer-rated measures that are administered at set times during episodes of inpatient, ambulatory and community residential episodes of care. Routine outcome measurement is now embedded in service delivery, and data are made available in a variety of ways to different audiences. These data are used by policy-makers and planners to inform decisions about system-wide reforms, by service managers to monitor quality and effectiveness, and by clinicians to guide clinical decision-making and to promote dialogue with consumers. Consumers, carers and the general community can use these data to ensure that services are accountable for the care they deliver. This paper describes the status quo in Australia with respect to routine outcome measurement, discusses the factors that led to its successful implementation, and considers the steps that are necessary for its continued development.

Implementation of a recovery-oriented model in a sub-acute Intermediate Stay Mental Health Unit (ISMHU)

“…Selected assessment measures, routinely collected as part of the national outcomes set [38], were obtained via the regional Clinical Information and Management Exchange (CHIME), including: the Health of the Nation Outcomes Scales (HoNOS; [39]); and the Kessler psychological distress scale (K10; [40]). Twelve items are assessed in the HoNOS: problems with behaviour (3 items); impairment (2 items); symptoms (3 items); and social functioning (4 items).…”

Longitudinal comparative evaluation of the equivalence of an integrated peer-support and clinical staffing model for residential mental health rehabilitation: a mixed methods protocol incorporating multiple stakeholder perspectives

“…It is hypothesised that there will be no significant difference in the mean change in highest total HoNOS score recorded in the 0–12 months prior to CCU commencement and the highest score recorded 0–12 months post CCU discharge for consumers under the clinical and integrated staffing model. The total HoNOS score has been selected as the primary outcome measure as it: Has high validity, reliability and sensitivity to change, as well as routinely informing service policy and planning decisions in Australia [ 38 ]; Is considered appropriate for tracking changes in social functioning over time, and more sensitive in doing so than the CANSAS (a needs based measure) [ 39 ]; Has an embedded role in individual outcome assessment in Australia and New Zealand [ 38 , 40 , 41 ] and there is evidence that it is being regularly utilised in care planning [ 42 , 43 ] Is supported by an established national assessment protocol and training processes to facilitate inter-rater reliability [ 38 ], and with evidence to support higher levels of acceptability [ 44 ] and completion than the other core measures of routine outcome suite [ 38 ] It is used and available across multiple international settings [ 45 ], increasing the replicability of the methodology. …”

“…Has high validity, reliability and sensitivity to change, as well as routinely informing service policy and planning decisions in Australia [ 38 ];…”

“…Has an embedded role in individual outcome assessment in Australia and New Zealand [ 38 , 40 , 41 ] and there is evidence that it is being regularly utilised in care planning [ 42 , 43 ]…”

“…Is supported by an established national assessment protocol and training processes to facilitate inter-rater reliability [ 38 ], and with evidence to support higher levels of acceptability [ 44 ] and completion than the other core measures of routine outcome suite [ 38 ]…”