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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.

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).

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.

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.

Value-based healthcare suggested using patient-reported information to complement the information available in the medical records and administrative healthcare data to provide insights into patients' perceptions of satisfaction, experience and self-reported outcomes. However, little attention has been devoted to questions about factors fostering the use of patient-reported information to create value at the system level.

Action research design is carried out to elicit possible triggers using the case of patient-reported experience and outcome data for breast cancer women along their clinical pathway in the clinical breast network of Tuscany (Italy).

The case shows that communication and engagement of multi-stakeholder representation are needed for making information actionable in a multi-level, multispecialty care pathway organized in a clinical network; moreover, political and managerial support from higher level governance is a stimulus for legitimizing the use for quality improvement. At the organizational level, an external facilitator disclosing and discussing real-world uses of collected data is a trigger to link measures to action. Also, clinical champion(s) and clear goals are key success factors. Nonetheless, resource munificent and dedicated information support tools together with education and learning routines are enabling factors.

Current literature focuses on key factors that impact performance information use often considering unidimensional performance and internal sources of information. The use of patient/user-reported information is not yet well-studied especially in supporting quality improvement in multi-stakeholder governance. The work appears relevant for the implications it carries, especially for policymakers and public sector managers when confronting the gap in patient-reported measures for quality improvement.

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).

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.

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.

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

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.

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).

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.

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.

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.

Using data from a continuous and ongoing cross-sectional web survey on hospitalisation service experiences in two Italian regions, the authors used multilevel and multivariate logistic regression models to identify factors related to users' demographics, emotional and informative support, technical and physical aspects of the provision, influencing satisfaction and willingness-to-recommend, before and during a crisis.

The value-in-use, defined in terms of a positive or negative value given by the experience with services, can be evaluated by users and influenced by the context of provision. The authors tested whether and how the value-in-use of services changed in a context of crisis. This study is applied to the healthcare sector during the coronavirus disease 2019 (COVID-19) epidemic, by evaluating the impact of the pandemic on hospitalisation experience.

Overall, analyses of 8,712 questionnaires found a greater value after the pandemic spread. In a time of crisis, technical and informative aspects of care were found to be most valued by patients that may recognise the extraordinary professionalism of workers during the crisis.

This study empirically suggests that context can affect the evaluation of value-in-use by patients during unprecedented circumstances, producing additional value-in-context.

These findings imply that during critical periods where there is less scope for expressions of gratitude and appreciation towards front-line workers, user-reported data can be used for motivating professionals and increase resilience. These results reiterate the need to continue collecting and reporting the service users' voices, including as activity within plans for managing challenging situations.

The level of healthcare system distress, due to the COVID-19 epidemic, positively affects patients' propensity to recommend, which the authors suggest is driven by healthcare services' feelings of reverse compassion. These findings imply that during critical periods where there is less scope for expressions of gratitude and appreciation towards front-line workers, user-reported data can be used for motivating professionals and increase resilience, which can have positive social implications. These results reiterate the need to continue collecting and reporting the service users' voices, including as activity within plans for managing challenging situations.

Research based on the intersection of theoretical and empirical research regarding value-in-use, value-in-context and service quality measured through user experience is scarce, in particular in the healthcare sector. The authors' findings set the direction for future research on the influence of context on value creation and value creation's perception by users, on the concept of reverse compassion and on reverse compassion's impact on organisational well-being, particularly in times of crisis.

The outbreak of the COVID-19 pandemic has significantly impacted healthcare systems, presenting unforeseen challenges that necessitated the implementation of change management strategies to adapt to the new contextual conditions. This study aims to analyze organizational changes within the total hip replacement (THR) surgery pathway at multiple levels, including macro, meso and micro. It employs data triangulation from various sources to gauge the complexity of the change process and comprehend how multi-level decision-making influenced an unexpected shift.

A multicentric, single in-depth case study was conducted using a mixed-methods approach. Data sources included patient-reported outcome measures specific to the THR pathway and carefully structured in-depth interviews administered to managers and clinicians in two healthcare organizations serving the same population.

Decisions made at the macro level resulted in an overall reduction in surgical activities. Organizational changes at the meso level led to a complete cessation or partial reorganization of activities. Micro-level actions for change and adaptation revealed diverse and fragmented change management strategies.

Organizations with segmented structures may require a robust and structured department for coordinating change management responses to prevent the entire system from becoming stuck in the absorptive phase of change. However, it is important to recognize that absorptive solutions can serve as a starting point for genuine innovations in change management.

The utilization of data triangulation enables the authors to visualize how specific changes implemented in response to the pandemic have influenced the observed outcomes. From a managerial perspective, it provides insights into how future innovations could be introduced.

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.

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).

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.

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.

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.

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.

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

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.

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.