Transcript 4 Factor Model in Practice Screenshots

Guide to Clinical Outcome Reports
Care Pathways and Packages
Programme
Introduction
• From the data gathered through the Care Pathways and
Packages approach the Trust is now able to report on
clinical outcomes ie the impact our care packages are
having on our patients.
• The organisational and team level data is available via the
Q&P dashboard whilst individual patient-level data is
available either by drilling down on these reports, or direct
from the MHCT screen in the patient’s Rio record.
• The data can be subjected to sophisticated statistical analysis
but clinical teams should find the following graphs have some
immediate utility in determining progress for individual
patients and caseloads from entering a cluster to change of
cluster / discharge
• Screenshots of each graph have been annotated to explain
how they should be interpreted.
Graph 1: Overall outcomes for a caseload
(Change in total score for HoNOS element of MHCT)
Max possible improvement (i.e.
reduction in MHCT ratings) from
start of an episode of care to end
Lines representing average score
change (by cluster) for all patients
changing cluster / being
discharged in the reporting
period
Dots represent each patient and
their change in HoNOS total (NB
hover mouse to see if more than
1 patient made same change
Axis containing
each cluster
Effect size for each cluster i.e.
how significant the change is
(large effect size and
improvement = green, large
effect size and deterioration =
red, small-moderate effect sizes =
yellow)
Max possible deterioration(i.e.
increase in MHCT ratings) from
start of an episode of care to end
Summary: the higher up on the graph a line or dot is the better
and green effect sizes are best whilst red effect sizes are worst
Graph 2-4: Factor outcomes for a caseload
(Change in scores for each subset of MHCT scales)
Max possible factor improvement
(i.e. reduction in relevant MHCT
ratings) from start of an episode
of care to end
Lines representing average factor
score change (by cluster) for all
patients changing cluster / being
discharged in the reporting
period
Dots represent each patient and
their change in factor score (NB
hover mouse to see if more than
1 patient made same change
Axis containing
each cluster
Max possible factor
deterioration(i.e. increase in
relevant MHCT ratings) from start
of an episode of care to end
Summary: the higher up on the graph a line or
dot is the better
and green effect sizes are best whilst red
effect sizes are worst
Effect size for each cluster i.e.
how significant the change is
(large effect size and
improvement = green, large
effect size and deterioration =
red, small-moderate effect sizes =
yellow)
Summary: Factors are ‘themes’ made up of
related MHCT scales.
Personal wellbeing= scales 4+5+10+12
Emotional wellbeing = scales 2+7+8
Social wellbeing= scales 3+9+11+12
Severe disturbance = scales 1+6
(max score 16)
(max score 12)
(max score 16)
(max score 8)
Graph 5: Individual patient timeline
(Changes in total HoNOS and factor scores over time)
Use this axis when reviewing the
trends in factor totals
Use this scale when reviewing the
trends in total HoNOS score
Use this area to help understand
why a set of MHCT ratings were
recorded
Click on a plus symbol to see
what type of significant events
were recorded in Rio at a
particular point in time
Use this axis to understand when
a set of MHCT ratings were
recorded
Each line represents sets of MHCT
or SWEMWEBS ratings recorded
at each cluster review
Use this area to review the
changes in cluster that the
patient has made. NB factor
changes can also help explain
which area of a patients life has
improved / deteriorated
Summary:
This is a simple PSI timeline for use in CPA reviews to demonstrate and/or help understand
recovery and relapse from clinician and patient perspectives.
The lower each line is the better.
Be aware that each factor has a different maximum possible score (see previous slide)