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Routine measurement of mental health service outcomes: Health of the Nation Outcome Scales in Nova Scotia

^*School of Medicine, Room 2.15d, Building LO3, Logan Campus, Griffith University, University Drive, Meadowbrook, Queensland 4131, Australia, email: s.kisely{at}griffith.edu.au

Leslie Anne Campbell, Programme Coordinator and Heather Robertson, Psychologist

Departments of Psychiatry, Community Health and Epidemiology, Dalhousie University, and Health Outcomes Unit, Capital District Health Authority, Halifax

Doug Crossman, Programme Director and Karen Martin, Analyst

Mental Health Programme, South Shore Health, Bridgewater, Nova Scotia

John Campbell, Programme Director

Mental Health Programme, Annapolis Valley Health Authority, Wolfville, Nova Scotia, Canada

AIMS AND METHOD

Although the Health of the Nation Outcome Scales (HoNOS) were designed for routine clinical use, completion rates in clinical settings rarely exceed 60%. We evaluated two initiatives to increase completion rates: timely feedback to clinicians, useful at individual, team and service levels, and improved supporting materials (tabulated glossaries for all versions covering the lifespan).

RESULTS

Clinicians in South Shore Health district provided ratings on all out-patient referrals over 12 months as part of routine care. Data were captured using the Nova Scotia routine administrative data system. Completion rates rose from 61% to 86% (n=1190). Clinicians’ ratings of the instrument’s ease of use were significantly improved.

CLINICAL IMPLICATIONS

Use of a tabulated glossary and enhanced feedback of clinically useful information improved clinician support for the routine measurement of health outcomes with HoNOS.