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Outcomes Report 2017

Summary Report Outcomes 2017

Every year St Patrick’s Mental Health Services (SPMHS) publishes an Outcomes Report relating to clinical care pathways, clinical governance processes, clinical programmes and service user satisfaction rates. This summary provides some highlights in relation to analysis of the clinical outcomes for services provided by SPMHS. The detailed comprehensive full outcomes measures report is the seventh of its type produced by SPMHS and is central to the organisations promotion of excellence in mental health care. By measuring and publishing outcomes of the services we provide, we strive to understand what we do well and what we need to continue to improve.

Clinical Outcomes

In 2017 outcome measurement expanded to incorporate new clinical programmes and to further improve data capture for programmes already being measured. This report reflects a continuing shift towards an organisational culture that recognises the value of integrated outcome measurement in informing practice and service development.

Clinical Global Impression and Children’s Global Impression Scales

The Clinical Global Impressions Scale (CGI) is a clinician-rated mental health assessment tool used to establish the severity of illness (CGIS) at point of assessment and global improvement or change (CGIC) scored following care, treatment or intervention. The CGIS is rated on a 7-point scale, with the severity of illness scale rated from 1 (normal) through to 7 (most severely ill). CGIC scores range from 1 (very much improved) through to 7 (very much worse).

The Children’s Global Assessment Scale (CGAS) provides a global measure of level of functioning in children and adolescents, scored by the MDT on a scale of 1 to 100, which reflects the individual’s overall functioning level.    

 CGIC – Final Global improvement or change score (Adult inpatient service)


CGIC – Final Global improvement or change score

2015

2016

2017

 

Total

Total

Total

1

Very Much improved

13%

13%

15%

2

Much Improved

49%

37%

45%

3

Minimally Improved

16%

15%

15%

4

No Change

6%

5%

5%

5

Minimally Worse

0%

0%

0%

6

Much Worse

0%

0%

0%

7

Very Much Worse

0%

0%

0%

 

Not scored

16%

31%

20%

             

 

CGAS – Baseline & Final Assessment Scales (Willow Grove Adolescent Unit)

Children’s Global Assessment Scale

2015

2016

2017

Baseline

Final

Baseline

Final

Baseline

Final

100-91

Superior functioning

0%

0%

0%

0%

0%

0%

90-81

Good functioning

0%

0%

0%

0%

0%

0%

80-71

No more than a slight impairment in functioning

0%

0%

0%

0%

0%

0%

70-61

Some difficulty in a single area, but generally functioning pretty well

0%

12%

0%

45%

0%

26%

60-51

Variable functioning with sporadic difficulties

33%

68%

24%

38%

7%

68%

50-41

Moderate degree of interference in functioning

55%

10%

61%

8%

56%

2%

40-31

Major impairment to functioning in several areas

6%

0%

12%

4%

36%

2%

30-21

Unable to function in almost all areas

0%

0%

4%

0%

1%

1%

20-11

Needs considerable supervision

0%

0%

0%

0%

0%

0%

10-1

Needs constant supervision

0%

0%

0%

0%

0%

0%

 

Not scored

6%

10%

0%

5%

0%

0%

Mean ±SD

49±5

57±4

45±7

59±7

41±6

57±6

Median

50

57

45

59

42

58

Wilcoxon Signed Ranks Test: 

Z=-5.983, p<.001

Z=-5.485, p<.001

Z=-7.841, p<.001

Outcome of Adolescent Assessments 2017

Overall views of St Patrick’s Mental Health Services

Those who completed and returned the Service User Satisfaction Survey within our adult inpatient services demonstrated a high level of satisfaction with the care they received.

Average Ratings of Care and Treatment and the Hospital Overall (scale 1-10)

How would you rate?

No.

Mean

Standard Deviation

Your care and treatment in Hospital

242

7.6

2.8

The Hospital, overall

246

7.8

2.7


Report Strengths

SPMHS continues to lead by example in providing such a detailed insight into service accessibility, efficacy of clinical programmes and service user satisfaction. Reporting this breadth of routinely collected clinical outcomes, demonstrates a willingness to constantly re-evaluate the efficacy of our clinical programmes/services, in an open and transparent way. The full report includes a detailed service user satisfaction survey encompassing all service delivery within SPMHS, reinforcing the organisation’s commitment for service user centred care and treatment.      

Report Challenges

Whilst we have continued with our expansion of services included within the full report, as yet we do not have all areas of service delivery included. Efforts to benchmark the results of the report remain very difficult, as no other organisation within Ireland produces a comparable report. In order to best capture the efficacy of clinical programmes and services, there have been changes in the outcome measures used, which can create difficulties when comparing results to previous reports. The report’s clinical outcome results cannot be solely attributed to the service or intervention being measured and are not developed to the standard of randomised control trials.