A ROM Champion Network was set up at Tees, Esk and Wear Valley NHS Foundation Trust’s Children and Young People’s Services (CYPS) to put practising clinicians in a role of expertise and responsibilty in supporting the use of outcome measures in their teams. At a service level, the aim was to increase the use of outcome measures,
but there was also regular anecdotal feedback that suggested clinicians found it difficult to choose which outcome measures to use, didn’t know how to introduce them to young people and families or understand the information they provided. Team managers were asked to nominate suitable representatives to be a ROM Champion, or act as champion themselves if they felt this better integrated with their team dynamic. The ROM Champion directly supported the use and understanding of outcome measures by clincians, and the interpretation of outcome data by team managers. The role was supported by service leads and managers, who encouraged time to be allocated in job plans for nominated clinicians to fulfil the role. Key duties included:
| Activity | Recommended frequency |
| Providing a weekly “ROM Clinic”, assisting clinicians in understanding why, how and when to use ROMs, and providing guidance on how to record and analyse data using electronic patient systems |
1hr/week |
| Leading regular discussions about the clinical use of ROMs, including presenting case-studies using ROMs |
1hr/month |
| Providing refresher ROM Training to team | 1-hour per quarter, as part of Business meeting |
| Attending regular Regional Implementers Meetings hosted by the Child Outcomes Research Consortium (CORC) |
Half-day every 6 months |
| Assisting managers in improving quality of ROM data using the inhouse reports which detail the use of outcome measures by each team |
Regular ROM slot in team meetings to feedback on performance |
| Liaising with CYPS Payment by Results team to ensure data quality | Ongoing |
| Networking with other ROM champions to support the Trust-wide embedding of outcome measures |
Ongoing |
| Monitoring intra-team feedback on the use of outcome measures including examples of both difficulties and best practice, and feeding back to CYP-IAPT Leads |
Ongoing |
| Receiving briefings from the CYP-IAPT leads on organisational and national situation |
2hrs/month |
Clinicians say...
• it’s helpful to have an identified person who is “always there for advice and answers questions” on ROMs
• positive aspects of having a Champion included increased provision of training, the availbility of ad-hoc drop in sessions and presentations
• need for further support with time required to record ROMs on the electronic system and meaningful interpretation of data
• “[There were] glitches in the (electronic) system, such as being unable to create a graph when symptom tracking to demonstrate change to young people.”
• “ROM form itself is cumbersome, needs number of items taken out so becomes a much sleeker form to complete.”
• “Difficulties with technology in producing graphs (symptom trackers) to share with the clients.”
ROM Champions say...
• implementation of the role has been considered differently across teams, with each focusing on different areas of
support
• clinicians require additional support to record ROMs electronically
• additional clarity around role required to be more effective
• training to fully understand measures and interpretation of them is necessary
• “Team did not like the weekly ROM clinics as we are a small team they find it easier to grab ‘as and when needed’.”
• “I’m slowly starting to understand my role as a Role Champion; however this is made much more difficult as I haven’t had any training on ROMs. Due to this I’m a bit more apprehensive in announcing my role
Next steps
• The feedback collected suggested that clinicians and ROM Champions value the support offered through the ROM Champion Network and there is improved understanding and confidence in using outcome measures routinely.
• The integration of outcome monitoring and patient record systems is a key area requiring more support to ensure maximum use of outcome measures
• ROM Champion Network and CYPS Payment by Results colleagues have begun developing further training materials and resources to empower ROM Champions in their role
• CYPS leads are engaged in ongoing discussions and liaison with the Trust’s electronic systems teams to improve interaction between clinicians and patient systems when entering and scoring measures
• The Trust will continue monitoring use of outcome measures within CYPS, gathering feedback on best practice and addressing the difficulties faced by clinicans.
Many thanks to Robb Hunt and Jennifer Jones, Assistant Psychologists at Tees, Esk and Wear Valley for providing the information included in this case study.