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Article
Publication date: 9 December 2011

David Walton, Michael Fullerton and Seraphim Patel

This paper seeks to discuss the collaborative development and piloting of joint user outcome measures for older adults with mental health problems (OAMH) and their carers…

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Abstract

Purpose

This paper seeks to discuss the collaborative development and piloting of joint user outcome measures for older adults with mental health problems (OAMH) and their carers. Outcome measures are crucial to measuring the impact of services on people's lives and are central to the new NHS and Adult Social Care (ASC) Outcome Frameworks.

Design/methodology/approach

The paper describes the development of a joint user outcome measure based on ASC User Experience Surveys (UES) and User Outcome Measures, and NHS Patient Reported Outcome Measures (PROMS) and Patient Reported Experience Measures (PREMS).

Findings

The aim was to supplement existing clinical outcome measures (HONOS65+) with holistic measures of the impact of services on the lives of patients, easy to administer, covering a range of health and social care outcomes and meeting both health and social care outcome requirements.

Originality/value

As far as is known this is one of the first tests of a joint patient reported experience and outcome measure. Such measures may enable joint services to: measure wider outcomes as well as clinical outcomes; meet the new focus on outcomes; and enable more systematic collection of outcome and effectiveness/Value for Money (VFM) data. There are also lessons about collaborative working and development.

Details

Quality in Ageing and Older Adults, vol. 12 no. 4
Type: Research Article
ISSN: 1471-7794

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Article
Publication date: 20 June 2016

Shelley Marie Norman, Tamsin Ford, William Henley and Robert Goodman

Routine outcome monitoring (ROM) is currently seen as a key driver for service improvement at individual, team and service level. The purpose this paper is to explore the…

Abstract

Purpose

Routine outcome monitoring (ROM) is currently seen as a key driver for service improvement at individual, team and service level. The purpose this paper is to explore the relationships between a patient (parent) reported outcome measure (PROM), a practitioner reported outcome measure, and a patient (parent) reported experience measure (PREM).

Design/methodology/approach

A cohort of 302 primary school-age children was recruited and followed for one year from consecutively accepted referrals to three teams within two English Child and Adolescent Mental Health Services (CAMHS). Parents completed the Strengths and Difficulties Questionnaire (a PROM) and practitioners completed the Clinician Global Assessment Scale at baseline, six and 12 months; parents completed the Experience of Services Questionnaire (a PREM) at six and 12 months.

Findings

PROM and practitioner reported outcome measure data suggested poor clinical outcome in terms of symptoms, impact and levels of functioning but were accompanied by PREM evidence of high levels of satisfaction. There was an unexpectedly low correlation ( < 0.2) between both measures of outcome and satisfaction.

Originality/value

This paper fulfils a need to explore the relationships between different outcome measures to contribute to the understanding of ROM its validity.

Details

Journal of Children's Services, vol. 11 no. 2
Type: Research Article
ISSN: 1746-6660

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Article
Publication date: 8 February 2013

Tina Perry, Michael Barkham and Chris Evans

The purpose of this paper is to establish staff and patient opinions on the acceptability, feasibility, and utility of using the Clinical Outcomes in Routine Evaluations …

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319

Abstract

Purpose

The purpose of this paper is to establish staff and patient opinions on the acceptability, feasibility, and utility of using the Clinical Outcomes in Routine Evaluations – Outcome Measure (CORE‐OM) in secure hospitals.

Design/methodology/approach

Patients and nurses (male patients and their key workers) from high, medium and low secure hospitals participated in semi‐structured interviews after completing CORE‐OM or CORE‐OM (SV).

Findings

Template themes were acceptability, feasibility, relevance, suitability, changes to treatment, and understanding. Findings suggest that the CORE‐OM is acceptable and potentially useful in secure settings.

Practical implications

This paper suggests that the CORE‐OM is acceptable to patients and staff in secure settings and appears to be a feasible measure for such settings. Further research and accumulation of a referential database of item scores is needed for PROMS, including the CORE‐OM, to be fully useful in secure settings.

Originality/value

This paper will be of use to clinicians working with forensic mental health settings. It is one of only two papers which investigate the use of the CORE‐OM in forensic settings.

Details

The Journal of Forensic Practice, vol. 15 no. 1
Type: Research Article
ISSN: 2050-8794

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Book part
Publication date: 22 July 2021

Iris Wallenburg, Anne Essén and Roland Bal

Performance metrics have become widely used and much lamented – about tools for measuring healthcare quality. In this paper, the authors reflect on the development and use…

Abstract

Performance metrics have become widely used and much lamented – about tools for measuring healthcare quality. In this paper, the authors reflect on the development and use of performance metrics in healthcare regulation and clinical practice. Studying multi-actor settings of performance measurement systems in healthcare in Sweden and the Netherlands, the authors show how regulatory agencies (i.e., the inspectorate and national registries), patients, hospitals, and practitioners engage in the constitution of healthcare practices through developing performance indicators that form the input for ranking, ensuing intensive dialogues on what should be measured and accounted for, and to what effects. The authors analyze this process as caring for numbers. The authors discern two practices of caring for numbers: validating and contexting. Validating refers to the practices of making numbers reflect those practices they intend to depict; contexting is about how with the use of numbers specific contexts of healthcare are built. These processes together emphasize the performative character of numbers as well as the reflexive uses of performativity. The paper shows how collaborative and rather pragmatic practices of caring for numbers co-construct specific practices of healthcare. Though this reflexive entanglement of production and use of numbers actors not only constitute specific performance metrics and ranking practices but also perform healthcare.

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Article
Publication date: 19 April 2013

Archana Soni‐Jaiswal, Nadiah Parry and Nirmal Kumar

The published evidence in support of a tonsillectomy is equivocal relying on historical studies using objective outcome measures. Based on this, NICE have suggested that…

Abstract

Purpose

The published evidence in support of a tonsillectomy is equivocal relying on historical studies using objective outcome measures. Based on this, NICE have suggested that tonsillectomy is a “low clinical value treatment” and its funding curtailed by PCTs. This paper aims to prospectively evaluate the effect of a tonsillectomy on quality of life (QOL) of children affected by recurrent infective tonsillitis using a qualitative patient reported outcome measure (PROM).

Design/methodology/approach

Parents of children under the age of 16, undergoing a tonsillectomy, were enrolled. Parents completed a paediatric throat disorders outcome (PTDO) test prior to their child's surgery and then six months post‐operatively. Results were analysed using the Mann‐Whitney U test. The power of the study was 0.8 to detect a difference of 10 in a total score of 70.

Findings

A total of 63 children participated and an 86 per cent response rate was received at six months. The mean total score improved from 31.29 pre‐op to 7.41 post‐op (p<0.001). The mean score for the first two subgroups remained static but for the remaining 12 sub‐groups significantly improved post‐op.

Originality/value

The study demonstrates that performing tonsillectomies in a carefully selected cohort of children, significantly improves their QOL. It adds to a growing body of evidence that tonsillectomy is not a “low clinical value procedure” and has a substantial impact on the patients' symptoms.

Details

Clinical Governance: An International Journal, vol. 18 no. 2
Type: Research Article
ISSN: 1477-7274

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Article
Publication date: 16 November 2012

Helen Walker, Lindsay Tulloch and Colin Martin

Reports on quality of life (QOL) measures for forensic patients are severely limited. The present paper aims to consider how to assess chronic patient's well‐being and to…

Abstract

Purpose

Reports on quality of life (QOL) measures for forensic patients are severely limited. The present paper aims to consider how to assess chronic patient's well‐being and to identify and evaluate the content validity of measures used to assess health‐related QOL in psychosis.

Design/methodology/approach

A review was undertaken to gather information on the different QOL measures from relevant databases, exploring their strengths and weaknesses.

Findings

Results from the review indicate a broad range of assessment tools are used in practice, although very few have been used in forensic settings. A preference for subjective tools is emerging, in addition to patient rated scales as opposed to clinician rated scales.

Originality/value

The application of QOL measures in the forensic population is of particular interest and a relatively new area of study, thus of value to practicing clinicians. It is hoped that the use of appropriate tools will enhance understanding of the treatment and service needs for mentally disordered offenders.

Details

The British Journal of Forensic Practice, vol. 14 no. 4
Type: Research Article
ISSN: 1463-6646

Keywords

Content available

Abstract

Details

International Journal of Health Care Quality Assurance, vol. 21 no. 1
Type: Research Article
ISSN: 0952-6862

Keywords

Content available
Article
Publication date: 21 May 2020

Antti Peltokorpi, Juri Matinheikki, Jere Lehtinen and Risto Rajala

To investigate the effects of payor–provider integration on the operational performance of health service provision. The research explores whether integration governs…

Abstract

Purpose

To investigate the effects of payor–provider integration on the operational performance of health service provision. The research explores whether integration governs agency problems and tilts the incentives of diverse actors toward more systematic outcomes.

Design/methodology/approach

A two stage multimethod case study of occupational health services. A qualitative stage aimed to understand the reasons, mechanisms, and outcomes of payor–provider integration. A quantitative stage evaluated the performance of the integrated hospital against fee-for-service partner hospitals with a sample of 2,726 patients.

Findings

Payor–provider integration mitigates agency problems on multiple levels of the service system by complementing formal governance mechanisms with informal mechanisms. Compared to partner hospitals, the integrated hospital yielded 9% lower the total costs of occupational injuries achieved primarily by emphasizing conservative care and faster recovery.

Research limitations/implications

Focuses on occupational health services in Finland. Provides initial evidence of the effects of payor–provider integration on the operational performance.

Practical implications

Vertical integration may provide systematic outcomes but requires mindful implementation of multiple mechanisms. Rigorous change management initiative is advised.

Social implications

For patients, the research shows payor–provider integration of health services can be implemented in a manner that it reduces care costs while not compromising care quality and customer satisfaction.

Originality/value

This study provides a rare longitudinal analysis of payor–provider integration in health-care operations management. The study adds to the knowledge of operational performance improvement of health services.

Details

International Journal of Operations & Production Management, vol. 40 no. 4
Type: Research Article
ISSN: 0144-3577

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Article
Publication date: 31 December 2020

Lea Prevel Katsanis, Dennis Pitta and Anne Morinville

The purpose of this study is two-fold: first, to identify the degree of adoption of patient centricity in the pharmaceutical industry and second, to understand how the…

Abstract

Purpose

The purpose of this study is two-fold: first, to identify the degree of adoption of patient centricity in the pharmaceutical industry and second, to understand how the industry operationalizes this strategy. It is an important shift in the industry because of its central focus on the patient.

Design/methodology/approach

A content analysis was used based on publicly available documentation that includes industry publications, company and brand websites and clinical trial publications to identify the frequency of words used to describe patient centricity.

Findings

The key finding of this study is that the leading pharmaceutical firms overwhelmingly use patient support/access programs as the primary method of implementing patient centric strategies.

Research limitations/implications

Future research is needed to identify what impact these strategies have on patients; and whether or not these strategies have an impact on lowering drug prices and improved clinical outcomes for patients.

Practical implications

Future research is needed to identify what impact these strategies have on patients; and whether or not these strategies have an impact on lowering drug prices and improved clinical outcomes for patients. Limitations include the reliance on publicly available documentation.

Social implications

Pharmaceutical firms need to be aware that their publically available profile suggests a one-dimensional approach to patient centricity and this may influence the way patients, physicians and policymakers view their attitudes toward patients. This study is the first to systematically examine the activities of leading pharmaceutical firms with respect to the adoption and implementation of patient-centric strategies in a comprehensive fashion.

Originality/value

This study is the first to systematically examine the activities of leading pharmaceutical firms with respect to the adoption and implementation of patient-centric strategies in a comprehensive fashion.

Details

International Journal of Pharmaceutical and Healthcare Marketing, vol. 15 no. 1
Type: Research Article
ISSN: 1750-6123

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Article
Publication date: 23 September 2019

Henry Briscoe, Sarah Ashworth and Lyn Shelton

Individuals with an intellectual disability (ID) develop mental health difficulties at similar rates to individuals in the general population. Using Patient Reported

Abstract

Purpose

Individuals with an intellectual disability (ID) develop mental health difficulties at similar rates to individuals in the general population. Using Patient Reported Outcome Measures can help track deterioration and improve the outcomes of individuals seeking help for their difficulties. The Clinical Outcome in Routine Evaluation-Learning Disabilities (CORE-LD) is a multi-trait measure of psychological distress which has shown moderate test-rest reliability. However, the CORE-LD is yet to be validated for the population it was designed for. Therefore the purpose of this paper is to establish the concurrent validity of the CORE-LD in a population of individuals with a diagnosis of mild–moderate ID.

Design/methodology/approach

Participants with a diagnosis of mild–moderate ID, as well as other co-morbidities, were recruited from two UK inpatient hospitals and asked to complete the CORE-LD and its general population counterpart the Clinical Outcome in Routine Evaluation-Outcome Measure (CORE-OM).

Findings

Statistically significant differences were found regarding the CORE-LD across gender, with females scoring higher on the CORE-LD than males. There was no significant difference between security levels. The overall mean scores on each measure were moderately correlated. The data from this analysis suggest a significant positive correlation (rs=0.68).

Originality/value

This initial study’s findings have demonstrated the CORE-LD may have concurrent validity, and further replication studies in larger and more diverse samples are needed.

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