This is the abridged version of IWK Health Care's case study. To see the full version, please click here.
The IWK Health Centre Mental Health and Addictions (MHA) programme in Canada, recognized the essential need to understand whether, and how, their clients were achieving improved mental health outcomes. They believed joining CORC would provide them with the support and structure to meet their goals for routine outcome measurement.
Who was involved?
The programme is embedded in a paediatric tertiary care hospital and has over 30,000 individual visits a year from children and youth in Nova Scotia and three nearby provinces.
What was the problem?
MHA wanted to develop methods of outcome measurement that aligned with the hospital’s strategic plan, allowing them to benchmark, demonstrate value, and improve health outcomes.
Unfortunately, they lacked a systematic approach to meaningfully engaging patients in feedback, or to using outcome monitoring data to support decision making with patients, teams and leaders and inform clinical practice and program planning.
Their previous evaluation structures also did not let them benchmark against similar health care providers, to guide their understanding of what treatment outcomes should be considered acceptable, or provide a standard method to drive treatment outcome improvement.
Using paper based measures, one major limitation was the lack of an IT system that allowed them to administer measures electronically, score them in real time, track evaluation data alongside demographic or schedule data to allow clinicians easy and timely access to outcomes for review with clients.
The programme also lacked a specific avenue for sharing outcome data at a regional, provincial, or national level.
Tackling the problems
Since joining CORC in January 2017, and gaining access to a network of international mental health service providers, MHA are beginning to find solutions to the challenges of how best to measure outcomes in various paediatric mental health settings. They have:
- Gained access to CORC support and implemented the CORC approach, supporting practice and decision making in identifying effective interventions, practitioner development, service quality review and improvement, cross-sector service design, and real-world effectiveness research
- Implemented the CORC Best Practice Framework, an invaluable resource in planning next steps
- Benchmarked against international standards, and added their data to CORC’s extensive data set
- Accessed customized outcome reports
- Attended the CORC implementers meeting which offered an intense opportunity for networking.
- Attended webinars; workshops/education sessions and come in person to the CORC Forum.
In implementing CORC approaches to routine outcome monitoring, the service learnt that:
- Routine outcome monitoring is vitally important to understanding and responsibly delivering MHA services
- MHA did not have the infrastructure to do this well – e.g. submitting data to CORC involved pulling data from three sources, and completing multiple data checks. While this was time consuming, it was also useful in identifying opportunities to improve data collection and data integrity
- MHA needed a structure to assist in guiding the development of their ROM process.
- Joining CORC has provided the IWK MHA program with a low-cost investment that:
- supports their processes to achieve standard outcome measurement through the shared knowledge of the members of CORC
- provides access to a network of evaluation expertise to aid in our knowledge acquisition, and supported our efforts of knowledge translation
- MHA intend to use the CORC Best Practice Framework both for strategic planning and also as a communication tool to explain their ROM goals and objectives to patients, families, staff and leadership
- They will be coordinating the collection of data from our Community based mental health and addictions clinics (CMHA); serving over 5300 unique patients per year across three sites
- They will be piloting a program to place current outcome measures (SDQ and goal-based measures), on an electronic platform to capture real time data and reduce manual labour.
Following their recent data submission, MHA will provide quarterly up-dates on their own outcomes and compare these with other service providers. This data sharing will be informative for the evaluation team, and clinicians providing direct care making the work they do every day feel more informed and spur on continuous service improvement efforts.
Many thanks to Dr Susan McWilliam, Dr Debbie Emberly and Dr Leslie Anne Campbell for providing us with this case study.