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National Benchmarking Project

National Benchmarking Project. Southern CAMHS Southern Adelaide Health Service HRT0801 MHBG. Overview. Benchmarking – what is the point? How do we compare with the other CAMHS? Are we under/over resourced? Who do we see? What is the profile of the client group we see?

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National Benchmarking Project

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  1. National Benchmarking Project Southern CAMHS Southern Adelaide Health Service HRT0801 MHBG

  2. Overview Benchmarking – what is the point? • How do we compare with the other CAMHS? • Are we under/over resourced? • Who do we see? • What is the profile of the client group we see? • Are we good or good enough? • What are our problem areas? • Can we learn from the B/m process?

  3. US

  4. Indicators versus Targets • National Benchmarking is about indicators. • Indicators are measures that are set to see how service compares against another. They are relative measures. • Targets are the end point or goal we may decide to aim for or they may be a clearly defined expectation. • Indicators are not targets but rather a means of comparison.

  5. Some Comparisons: How do our staffing levels compare? FTE per 100,000 population

  6. What does our client group look like? Comparison of Principle Diagnosis

  7. Where does our day go?

  8. Service Accessibility • Population receiving ambulatory services over 2 year period is higher than the national average • The figure for 2004-2005 was highest at 3.4% of the target population. The group average was 1.6% and the lowest was 0.7% • Averaged to 2.9% for 2004/05-2005/06

  9. Comparison of target population receiving a service 2005/06

  10. The “Open Door” Policy • An open door policy or Primary Referral system has led to high accessibility (higher than previously noted in other services in Australia or New Zealand). The range of acuity of cases has maintained a capacity to provide equivalent to the national average of direct clinical service hours. Other services with more restricted access have significantly lower clinical hours.

  11. How we compare with caseloads Number of people seen Ambulatory Care per FTE 2005-2006

  12. Comparison: number of sessions per clientepisode • We were the lowest average treatment of 4.1 compared to the group average 8.7 (Dopey had the highest treatment days at 20.6. They have no access to an inpatient unit – all clients are treated in the community.) • However averages can be misleading - large variation in number of treatment sessions. • Average probably distorted by the large number of “assessment only” contacts in metro areas.

  13. Assessment Only • “Assessment only” episodes - average of 34% across the SCAMHS • There is internal variation between Country Services and Metro. Teams • Metro Teams average single session for half of all new cases.

  14. Snapshot of variation in treatment times

  15. HONOSca Comparison

  16. HONOSca Comparison - contd

  17. Changing Population Profile:Nearly 50% of clients aged 13 to 17 yrs

  18. Specific Service Comparison Sneezy versus Grumpy

  19. Specific Service Comparison • Southern CAMHS has retained an open door policy and sees 3 times the percentage population as Sneezy CAMHS • Sneezy CAMHS has implemented the UK’s tertiary model of care for tier 2/3: they only see certain diagnostic categories themselves and refer out others.

  20. Tier 2/3 UK Diagnostic categories • Assessment and treatment of psychiatric and neurodevelopmental disorders • Psychosis, depressive disorders • ADHD, Autistic spectrum disorders • Self Harm and Suicide attempts • Phobias and anxiety disorders • Obsessive Compulsive Disorder • Mental health problems secondary to abuse

  21. Model of care/other models Sneezy had the lowest direct clinical hours in the staff survey because of the complexity of the their cases (?) Grumpy sits on the group average.

  22. How it’s working for Sneezy CAMHS:– (according to Sneezy CAMHS) • HONOSca clinical score range is higher • Lower staff levels per population • Lowest caseloads of all the dwarves • Still have waiting lists but queued before treatment. • Major Workforce issues. • Clinicians are “overloaded and burnt out” • (Desperately) looking for a new model of care

  23. Where to from here? - contd • What changes can we make to improve client flow while maintaining high clinical standards? • PDSA Cycles to prove their effectiveness. • What feedback can we give to those who are building new KPI’s as part of the ongoing National Benchmarking Project? What do you think ?

  24. ORGANISATIONAL Performance Indicators Clinical Protocol Package based on KPI Evidence and Redesigning Care Principles • Caseload per Clinician - reduced to 30-35 • Therapeutic Contact Hours – 12 to 16 • Therapeutic “Case Mix” – Tier 1 to 3 • Length of Therapy (Therapeutic dose) – 6/12/18 • Diagnostic Categories –Orientation and Training • NOCC Compliance –Reporting and Training

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