Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-25T13:02:00.985Z Has data issue: false hasContentIssue false
  • English
  • Français

Embracing performance measurement in mental health services

Published online by Cambridge University Press:  24 May 2013

H. Carrick ,
R. Purcell  and
M. Byrne
H. Carrick
Affiliation:
Roscommon Service Area, Health Service Executive (HSE) West, Roscommon, Ireland
R. Purcell
Affiliation:
Roscommon Service Area, Health Service Executive (HSE) West, Roscommon, Ireland
M. Byrne*
Affiliation:
Roscommon Service Area, Health Service Executive (HSE) West, Roscommon, Ireland
*
*Address for correspondence: M. Byrne, Roscommon Service Area, Health Service Executive (HSE) West, Primary Care Centre, Golf Links Road, Roscommon, Ireland. (Email michaelj.byrne@hse.ie)
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives

Performance measurement (PM) is central to the current Irish health service policy. However, PM within the Irish mental health services has not been fully implemented. These services lack a national comprehensive suite of performance indicators (PIs). Those indicators that are measured do not tend to reflect the objectives of the managers and staff measuring them. To overcome these challenges, this article suggests a suite of measures and aims to provide a practical guide to PM for managers and staff.

Method

A narrative review of a range of policy documents and articles, relevant to PM in the Irish mental health services, was undertaken.

Findings

The search produced a number of themes illustrating the limitations of the current set of PIs for Irish mental health services, in particular the need for comprehensive PIs, including structure, process and outcome PIs. This informed the development of a suite of proposed PIs for mental health services. A number of additional themes highlighted the criticisms associated with the top-down approach used to implement PM. Drawing from these themes, a bottom-up approach to PM is proposed.

Conclusion

Although this review was selective in nature, it illustrates how the concerns of clinicians and service managers can be integrated with the priorities of the Health Service Executive and the Department of Health. This presented the suite of PIs and the practical guide that provide useful PM tools. While also applicable at a national level, this paper provides guidance for service managers as to the process of establishing and implementing a suite of PIs within their own service.

Keywords

Irish health servicemental healthperformance indicatorsperformance managementperformance measurement
Type
Review Article
Information
Irish Journal of Psychological Medicine , Volume 30 , Issue 3 , September 2013 , pp. 209 - 219
Copyright
Copyright © College of Psychiatrists of Ireland 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adair, C, Simpson, L, Birdsell, J, Omelchuk, K, Casebeer, A, Gardiner, H, Newman, S, Beckie, A, Clelland, S, Hayden, K, Beausejour, P (2003). Performance Measurement Systems in Health and Mental Health Services: Models, Practices and Effectiveness. The Alberta Heritage Foundation for Medical Research: Alberta.Google Scholar
Baars, I, Evers, S, Arntz, A, van Merode, G (2009). Performance measurement in mental health care: present situation and future possibilities. The International Journal of Health Planning and Management 25, 198–214.CrossRefGoogle Scholar
Ballantine, J, Brignall, S, Modell, S (1998). Performance measurement and management in public health services: a comparison of UK and Swedish practice. Management Accounting Research 9, 71–94.CrossRefGoogle Scholar
Berwick, DM (2003). Improvement, trust, and the healthcare workforce. Quality & Safety in Health Care 12, 448–452.CrossRefGoogle ScholarPubMed
Bodart, C, Shrestha, L (2000). Identifying information needs and indicators. In World Health Organisation, Design and Implementation of Health Information Systems (ed. T. Lippeueld, R. Sauerburn, C. Bodart), pp. 49–72. WHO: Geneva.Google Scholar
Byrne, M, Onyett, S (2010). Teamwork Within Mental Health Services in Ireland. Mental Health Commission: Dublin.Google Scholar
Canadian Institute for Health Information and Statistics (CIHIS) (2000). Canadian Health Information Roadmap Initiative Indicators Framework. CIHIS: Canada.Google Scholar
Chisholm, D (1998). Costs and outcomes of psychotherapeutic approaches to treatment of mental disorders. Community Mental Health Review 5, 53–55.Google Scholar
Clarkson, P, Challis, D (2002). Developing performance indicators for mental health care. Journal of Mental Health 11, 281–293.CrossRefGoogle Scholar
Clinical Outcomes in Routine Evaluation (CORE) (2012). The CORE system-overview (http://www.coreims.co.uk/index.php?name=EZCMS&menu=100&page_id=1&menu=1). Accessed 22 February 2012.Google Scholar
Department of Health (DoH) (2006). A Vision for Change: Report of the Expert Group on Mental Health Policy. Dublin Stationary Office: Dublin.Google Scholar
Department of Health (DoH) (2009). Implementing the NHS Performance Framework: Application to Mental Health Trusts. DoH: London.Google Scholar
Donabedian, A (1980). The Definition of Quality and Approaches to its Assessment. Health Administration Press: Ann Arbor, MI.Google Scholar
Glover, G (1995). Mental health informatics and the rhythm of community care. British Medical Journal 311, 1038–1039.CrossRefGoogle ScholarPubMed
Government of Ireland (2001). Mental Health Act. Dublin Stationary Office: Dublin.Google Scholar
Grote, D (2000). Public sector performance management. Public Personnel Management 29, 1–20.CrossRefGoogle Scholar
Harnett, PJ, Bowles, N, Coughlan, A (2009). Refocusing acute psychiatry, performance management, standards and accountability, a new context for mental health nursing. Journal of Psychiatric and Mental Health Nursing 16, 434–439.CrossRefGoogle ScholarPubMed
Health Care Commission (2008). National NHS Patient Survey Programme: Survey of Users of Community Mental Health Services. HCC: London.Google Scholar
Health Information and Quality Authority (2010). Guidance on Developing Key Performance Indicators and Minimum Data Sets to Monitor Healthcare Quality. HIQA: Dublin.Google Scholar
Health Service Executive (HSE) (2013). National Service Plan 2013 (http://www.hse.ie/eng/services/Publications/corporate/NSP2013.pdf). Accessed 10 February 2013.Google Scholar
Hermann, R, Mattke, S (2004). Selecting indicators for the quality of mental health care at the health systems level in OECD countries (http://ideas.repec.org/p/oec/elsaae/17-en.html). Accessed 27 February 2013.Google Scholar
Hoch, J, Smith, M (2006). A guide to economic evaluation: methods for cost-effectiveness analysis of personal-level data. Journal of Traumatic Stress 19, 787–797.CrossRefGoogle Scholar
Indecon (2010). Accountability in the delivery of a vision for change – a performance assessment framework for mental health services (http://amnesty.ie/reports/accountability-delivery-vision-change-performance-assessment-framework-mental-health-service). Accessed 4 February 2012.Google Scholar
Irish Society for Quality and Safety in Healthcare and the Mental Health Commission (2012). Your Views of Mental Health Inpatient Services. University of Ulster: Ulster.Google Scholar
Kilbourne, A, Keyser, D, Pincus, H (2010). Challenges and opportunities in measuring the quality of mental health care. Canadian Journal of Psychiatry 55, 549–557.CrossRefGoogle ScholarPubMed
Lilford, R, Mohammed, MA, Spiegelhalter, D, Thomson, R (2004). Use and misuse of process and outcome data in managing performance of acute medical care: avoiding institutional stigma. The Lancet 363, 1147–1154.CrossRefGoogle ScholarPubMed
Mant, J (2001). Process versus outcome indicators in the assessment of quality of health care. International Journal for Quality in Health Care 13, 475–480.CrossRefGoogle ScholarPubMed
McEwan, K, Goldner, E (2001). Accountability and Performance Indicators for Mental Health Services and Supports – A Resource Kit. Prepared for the Federal/Provincial/Territorial Advisory Network on Mental Health. Health Canada: Ontario.Google Scholar
McMillen, C, Zayas, L, Books, S (2008). Quality assurance and improvement practice in mental health agencies: roles, activities, targets and contributions. Administration and Policy in Mental Health 35, 458–467.CrossRefGoogle ScholarPubMed
Mental Health Commission (MHC) (2007). Quality Framework, Mental Health Services in Ireland. MHC: Dublin.Google Scholar
Merrigan, M (2007). Finding Common Ground. In The Politics of Healthcare, Achieving Real Reform (ed. E. McAuliffe and K. McKenzie), pp. 121–135. Liffey Press: Dublin.Google Scholar
Moullin, M (2004). Eight essentials of performance measurement. International Journal of Health Care Quality Assurance 17, 110–112.CrossRefGoogle ScholarPubMed
Mundt, J, Marks, L, Shear, M, Greist, J (2002). The Work and Social Adjustment Scale: a simple measure of impairment in functioning. The British Journal of Psychiatry 180, 461–464.CrossRefGoogle Scholar
National Council for the Professional Development of Nursing and Midwifery (2010). Discussion Paper 3: Key Performance Indicators. NCPDNM: Dublin.Google Scholar
National Mental Health Working Group (NMHWG) Information Strategy Committee Performance Indicator Drafting Group (2005). Indicators for Australian Public Mental Health Services: ISC Discussion Paper No. 6. Australian Government Department of Health and Ageing: Canberra.Google Scholar
Ohio Department of Mental Health (2013). Ohio mental health consumer outcomes system. (http://mentalhealth.ohio.gov/what-we-do/protect-and-monitor/treatment-episode-outcomes/index.shtml). Acccessed 10 February 2012.Google Scholar
O'Shea, G, Byrne, M (in press). The Improving Access to Psychological Therapies Programme-opportunity knocks? The Irish Psychologist.Google Scholar
Psychological Society of Ireland (2008). Code of Professional Ethics of the PSI. PSI: Dublin.Google Scholar
Robinson, R (1993). Economic evaluation and health care cost-benefit analysis. British Medical Journal 307, 924–926.CrossRefGoogle Scholar
Roncalli, S, Byrne, M, Onyett, S (2013). Psychometric properties of a Mental Health Team Development Audit Tool. Journal of Mental Health 22, 51–59.CrossRefGoogle ScholarPubMed
Rosenheck, R, Cicchetti, D (1998). A mental health program report card: a multidimensional approach to performance monitoring in public sector programs. Community Mental Health Journal 34, 85–106.CrossRefGoogle Scholar
Smith, PC (2002). Measuring health system performance. The European Journal of Health Economics 3, 145–148.CrossRefGoogle ScholarPubMed
Twomey, C, Byrne, M, McHugh, P (submitted). Economic evaluation of mental health services. The Irish Journal of Psychological Medicine.Google Scholar
van Merode, G, Groothuis, S, Goldschmidt, HMJ (1999). Workflow management: changing your organization through simulation. Accreditation and Quality Assurance 4, 438–442.CrossRefGoogle Scholar
Wall, M 2012. Some €53 m of health investment to offset budget deficit. Irish Times (http://www.irishtimes.com/newspaper/health/2012/0911/1224323841304.html). Accessed 4 February 2013.Google Scholar
Weinberg, N (2001). Using performance measures to identify plans of action to improve care. Joint Commission Journal on Quality and Patient Safety 27, 683–688.Google ScholarPubMed
Wing, JK, Beevor, AS, Curtis, RH, Park, SB, Hadden, S, Burns, A (1998). Health of the Nation Outcome Scales (HoNOS). Research and Development. The British Journal of Psychiatry 172, 11–18.CrossRefGoogle ScholarPubMed
World Health Organisation (WHO) (2003). Quality Improvement for Mental Health – Mental Health Policy and Service Guidance Package. WHO: Geneva.Google Scholar
World Health Organisation (WHO) (2005). Mental Health Policy and Service Guidance Package, Mental Health Information Systems. WHO: Singapore.Google Scholar