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Paperless Outcome Measures 
The journey so far 
Feedback from Sheffield CAMHS 
Claire Pearson, Consultant Clinical Psychologist, 
Sheffield CAMHS and Service Lead for CYP-IAPT
Overview 
 Why? 
 History of the project 
 What it looks like 
 Experience of clinicians 
 What happens next 
 Questions
Why? 
 CYP-IAPT 
 Sheffield applied in 2013. Delay in applying due to 
wanting IT systems and Patient Recording systems to be 
fit for purpose. 
 Vision: Paper less ROM’s 
 Session by session routine outcome monitoring 
○ Collaborative – aids user participation in therapy 
○ Improves therapeutic alliance 
○ Help identify when interventions are not working 
○ Shorter care spell 
More paper!?.....
History of the project 
 Pilot Started in April 2012 
 Leeds and Sheffield won a joint bid and paid Strand to 
develop direct patient input of outcome measures. 
 Meetings with Strand, IT and IG departments - Ipads 
 Wi-fi installed at Beighton Jan 2013 
 Training re why use outcome measures 
 Pilot started in effect in July 2013 
 Cont…
Cont.. 
 Includes 3 patient-rated outcome measures 
 Session Rating Scale 
 Outcome Rating Scale 
 Goal Setting 
 Initial problems identified September 2013 
 Culture change – scheduling appointments! 
 Became part of the CYP-IAPT programme 
 Carenotes v.5 April 2014 corrected most of the issues 
 Centenary wi-fi December 2013. Received I pads June 
2014 
 Training from Northumbria University: May and June 
2014
What does it look like? 
 Screen shots 
 I pads – wifi only and because of IG 
issues will not work outside of the 
buildings 
 Patients used are ‘test’ patients – so no 
data protection issues.
Initial problems 
 Faces did not respond to touch 
 Can’t slide marker along the scale 
 Wrong wording of the questionnaires 
 Incorrect sequencing of questionnaires 
 Graphs made no sense / inaccessible 
 Short log out times 
 Clinicians feeling comfortable with I pads
Experience of clinicians 
 Engagement with families 
 Barrier / Tool 
 Application to range of clinical work 
 Art therapy, family therapy, medication review etc. 
 Clinician avoidance 
 Not wanting to inconvenience families 
 Not wanting to look incompetent! 
 Not compulsory & problems not rectified 
USUEse lMessORE 
MORE FAMILIAR 
Less familiar 
Takes longer 
Look more incompetent 
TAKES LESS TIME 
LOOK MORE COMPETENT!
What happens next 
 CY-IAPT target = 90% of cases with at least 2 
data points: 
 2 Patient Reported Outcome Measures (PROMS) 
○ ORS, SRS, Goals 
 2 standardised measures 
○ RCADS, SDQ 
○ Recorded on paper, transferred to CareNotes 
 Current view form 
○ Problem descriptions & Complexity factors 
Belief 
 Implementation date for CAMHS: 14th July 2014 
 More workshops, away days planned 
 Monthly feedback to staff 
Emotions
Sheffield Outcomes Team 
 Carenotes specialist 
 IT specialist 
 Assistant Psychologist 
 Outcomes lead 
 Monthly CYP-IAPT and ROM’s meetings 
with all key staff 
 Feedback to staff essential
Where are we now? 
 Still mixture of paper and paperless 
 We have just embarked on the whole service 
using outcome measures ( july – sept 2014) 
 124 new patients seen 
 85% current view 
 56% SDQ time one 
 15% RCADS time one 
 23% CORS 
 20 % SRS 
 9 % goals 
 28% given consent !
Questions

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Paperless Outcome Measures - The Journey So Far...Lessons learnt! - Claire Pearson

  • 1. Paperless Outcome Measures The journey so far Feedback from Sheffield CAMHS Claire Pearson, Consultant Clinical Psychologist, Sheffield CAMHS and Service Lead for CYP-IAPT
  • 2. Overview  Why?  History of the project  What it looks like  Experience of clinicians  What happens next  Questions
  • 3. Why?  CYP-IAPT  Sheffield applied in 2013. Delay in applying due to wanting IT systems and Patient Recording systems to be fit for purpose.  Vision: Paper less ROM’s  Session by session routine outcome monitoring ○ Collaborative – aids user participation in therapy ○ Improves therapeutic alliance ○ Help identify when interventions are not working ○ Shorter care spell More paper!?.....
  • 4. History of the project  Pilot Started in April 2012  Leeds and Sheffield won a joint bid and paid Strand to develop direct patient input of outcome measures.  Meetings with Strand, IT and IG departments - Ipads  Wi-fi installed at Beighton Jan 2013  Training re why use outcome measures  Pilot started in effect in July 2013  Cont…
  • 5. Cont..  Includes 3 patient-rated outcome measures  Session Rating Scale  Outcome Rating Scale  Goal Setting  Initial problems identified September 2013  Culture change – scheduling appointments!  Became part of the CYP-IAPT programme  Carenotes v.5 April 2014 corrected most of the issues  Centenary wi-fi December 2013. Received I pads June 2014  Training from Northumbria University: May and June 2014
  • 6. What does it look like?  Screen shots  I pads – wifi only and because of IG issues will not work outside of the buildings  Patients used are ‘test’ patients – so no data protection issues.
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  • 10. Initial problems  Faces did not respond to touch  Can’t slide marker along the scale  Wrong wording of the questionnaires  Incorrect sequencing of questionnaires  Graphs made no sense / inaccessible  Short log out times  Clinicians feeling comfortable with I pads
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  • 13. Experience of clinicians  Engagement with families  Barrier / Tool  Application to range of clinical work  Art therapy, family therapy, medication review etc.  Clinician avoidance  Not wanting to inconvenience families  Not wanting to look incompetent!  Not compulsory & problems not rectified USUEse lMessORE MORE FAMILIAR Less familiar Takes longer Look more incompetent TAKES LESS TIME LOOK MORE COMPETENT!
  • 14. What happens next  CY-IAPT target = 90% of cases with at least 2 data points:  2 Patient Reported Outcome Measures (PROMS) ○ ORS, SRS, Goals  2 standardised measures ○ RCADS, SDQ ○ Recorded on paper, transferred to CareNotes  Current view form ○ Problem descriptions & Complexity factors Belief  Implementation date for CAMHS: 14th July 2014  More workshops, away days planned  Monthly feedback to staff Emotions
  • 15. Sheffield Outcomes Team  Carenotes specialist  IT specialist  Assistant Psychologist  Outcomes lead  Monthly CYP-IAPT and ROM’s meetings with all key staff  Feedback to staff essential
  • 16. Where are we now?  Still mixture of paper and paperless  We have just embarked on the whole service using outcome measures ( july – sept 2014)  124 new patients seen  85% current view  56% SDQ time one  15% RCADS time one  23% CORS  20 % SRS  9 % goals  28% given consent !