KPIs for Australian Public Mental Health Services: PI 14J – Outcomes readiness, 2015

Identifying and definitional attributes

Metadata item type:Indicator
Indicator type:Indicator
Short name:MHS PI 14J: Outcomes readiness, 2015
METeOR identifier:597117
Registration status:Health, Standard 19/11/2015
Description:

Proportion of mental health care episodes with completed clinical outcome measures at both baseline and follow-up.

NOTE: This indicator has been adapted from the indicator MHS PI 14: Outcomes readiness, 2015 (Service level version) using terminology consistent with the National Health Data Dictionary. There are technical differences in the consumer groups listed in the methodology section between the Service level version and the Jurisdictional level version of this indicator. Caution should be taken to ensure the correct methodology is followed.

Rationale:
  • Capable services are results oriented and regularly monitor consumer outcomes.
  • All states and territories have committed to routinely measuring public sector mental health service outcomes.
  • Sufficient coverage of outcome measures will enable a standard where information can be effectively used and interpreted to inform and improve clinical practice and service delivery.
Indicator set:Key Performance Indicators for Australian Public Mental Health Services (Jurisdictional level version) (2015) Health, Superseded 11/05/2016

Collection and usage attributes

Computation description:

Coverage/Scope:

State/territory specialised mental health care services. 

The following episodes of mental health care (and related outcomes measures) are excluded:

The following services are excluded:

  • Australian Government funded aged residential services.

Methodology:

  • Reference period for 2015 performance reporting: 2013–14.
  • Only the Health of the Nation Outcome Scales (HoNOS) family of measures (including HoNOS, HoNOS65+ and HoNOSCA) is considered in the calculation of this indicator.
  • Outcomes readiness is calculated for the following consumer groups:
    • Group A: Consumers discharged from hospital. All people who were discharged from an acute admitted patient mental health care service unit within the reference period, with a completed clinical outcome measure collected at both admission (the ‘baseline’) and discharge (the ‘follow-up’). 
    • Group B: Consumers discharged from ambulatory care. All people who were discharged from an ambulatory care episode, provided by an ambulatory mental health care service, within the reference period, with a completed clinical outcome measure collected at both admission (the ‘baseline’) and discharge (the ‘follow-up’). Ambulatory episodes that are completed because the consumer was admitted to hospital or residential mental health care are excluded from the analysis (that is, where the National Outcomes Casemix Collection (NOCC) ‘reason for collection’ equals change of setting). 
    • Group C: Consumers in ongoing ambulatory care. All people who have an ‘open’ ambulatory episode of mental health care at the end of reference period, where there is a completed clinical outcome measure collected at both the first occasion rated within the reference period, which will be either an admission or review (the ‘baseline’), and the last occasion rated, which will be a review (the ‘follow-up’), in the same reference period.
Computation:

(Numerator ÷ Denominator) x 100

Calculated separately for each group.

Numerator:

Number of in-scope episodes of mental health care with completed outcome measures at both baseline and follow-up within the reference period.

Numerator data elements:
Data Element / Data SetData Element

Number of episodes with a completed outcome measure at both baseline and follow-up

Data Source

National Outcomes and Casemix Collection (NOCC)


Guide for use
For purposes of this indicator, a completed clinical outcome measure is defined as one where the number of items completed is consistent with that provided in 95% of assessments. Translated to individual rating scales this would mean:
- For the HoNOS/65+, a minimum of 10 of the 12 items
- For the HoNOSCA, a minimum of 11 of the first 13 items
Denominator:

Number of in-scope episodes of mental health care within the reference period.

Denominator data elements:
Data Element / Data SetData Element

Specialised mental health service—number of admissions

Data Sources

Community Mental Health Care NMDS

Admitted Patient Care NMDS


Disaggregation:

Service variables: Setting (Group A, B or C) 

Consumer variables: Age (0-17, 18-64, 65+)

Disaggregation data elements:
Data Element / Data SetPerson—age, total years N[NN]
Guide for use
Age to be calculated as at the start of the episode of care
Data Element / Data SetData Element

Person—setting

Data source

National Outcomes and Casemix Collection (NOCC)


Guide for use

Group A: Consumers discharged from hospital

Group B: Consumers discharged from ambulatory care

Group C: Consumers in ongoing ambulatory care


Representational attributes

Representation class:Percentage
Data type:Real
Unit of measure:Service event

Indicator conceptual framework

Framework and dimensions:Capable

Accountability attributes

Benchmark:

State/territory level

Further data development / collection required:

Estimates of the total number of episodes requiring outcomes assessment is not provided directly to the National Outcomes and Classification Collection, however this can be approximated from the NMDSs (Community Mental Health Care, Admitted Patient Mental Health Care and Residential Mental Health Care).

A proxy solution is to use estimates from the NMDSs (Community Mental Health Care, Admitted Patient Mental Health Care and Residential Mental Health Care).

Longer term, a process is needed that allows data reported to the NOCC for consumers who begin an episode in a given year to be tracked when the episode continues into subsequent years. Work is underway to build in an episode identifier into the NOCC and Community Mental Health Care NMDS to enable this. Additionally, consistent, cross-year use of service identifiers and unique identifiers for consumers by states and territories is necessary to enable full capacity to construct this indicator using the NOCC.

Other issues caveats:

Further definition of a ‘completed clinical outcome measure’ to resolve whether tolerance levels will be set to accept some degree of missing data also needs to be developed.

Source and reference attributes

Submitting organisation:Australian Institute of Health and Welfare on behalf of the National Mental Health Performance Subcommittee
Reference documents:Key Performance Indicators for Australian Public Mental Health Services, Third edition (2014)