Biomedical subjects

P Brann

Publications and source records attributed to P Brann.

3 recordsLinked to original sources

PubMed2001

Routine outcome measurement in a child and adolescent mental health service: an evaluation of HoNOSCA. The Health of the Nation Outcome Scales for Children and Adolescents.

OBJECTIVE: This paper evaluates a range of properties for a clinician-based instrument designed for routine use in a child and adolescent mental health service (CAMHS). METHOD: The Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) is a new outcome measure with great promise. Case vignettes were used to examine interrater reliability. HoNOSCA was implemented for routine outpatient use by multidisciplinary staff with a return rate of 84%. The 305 ratings obtained at assessment were analysed by age, gender and diagnosis. A sample of 145 paired ratings with a 3-month interval were examined for the measurement of change over time. RESULTS: Interrater reliability of the total score indicates moderate reliability if absolute scores are used and good reliability if the total score is used for relative comparisons. Most scales have good to very good reliability. The scales discriminated between age and gender in the expected way. HoNOSCA correlated with clinicians' views of change and was sensitive to change over a 3-month period. The total score seemed a proxy for severity. CONCLUSION: Routine outcome instruments must be explored in settings where they will be used and with realistic training. HoNOSCA appears to be of value in routine outcome measurement and although questions remain about reliability and validity, the results strongly support further investigation.

Adolescent↗

PubMed2001

Using program theory to develop key performance indicators for child and adolescent mental health services.

Key Performance Indicators are used increasingly by health services, but their relevance and utility may be questionable. In this article, Program Theory is used to model the irreducible stages in the system of clinical care in Child and Adolescent Mental Health Services, define the major program operations in each of these stages, and specify the intermediate outcomes of each stage and the final outcomes sought. National and State policy standards are used, with practice experience, to identify key program operations and intermediate outcomes sought. Systematic criteria are then applied to select KPIs that are measurable, reliable, valid for our program theory, utilitarian, and relevant to clinicians, clients and managers.

Adolescent↗

PubMed2000

Collaboration between general practitioners and a child and adolescent mental health service.

OBJECTIVE: The aim of this project was to develop a collaborative working relationship between general practitioners and a child and adolescent mental health service (CAMHS). METHODS: The project focused on changing the policies and culture within CAMHS to be more GP aware and inclusive. The project also provided GPs with an accredited training package on common mental health problems. The impact of the project was determined through pre and post project surveys and interviews with GPs and mental health workers (case managers) respectively. RESULTS: There was a two-fold increase in communication between the two sectors and a 120% increase in shared care arrangements. There was a 144% improvement in GPs' perceptions of the helpfulness of public CAMHS. DISCUSSION: Implications for future collaboration are discussed. The results of this pilot study are encouraging and warrant replication and validation using standardised instruments. CONCLUSION: To create, enhance and extend the working relationships between GPs and public CAMHS requires strategies for change in both sectors.

Adolescent↗