A Standards Approach to Embedding Rights in Mental Health Services Quality Framework Mental Health Services in Ireland Pat...
MHC statutory mandate Section 33, Mental Health Act, 2001  <ul><li>“ The principal functions of the Commission shall be to...
MHC statutory mandate Section 33, Mental Health Act, 2001  <ul><li>“ The Commission shall undertake or arrange to have und...
Key stages in developing the quality framework for mental health services in Ireland
Quality in Mental Health – Your Views <ul><ul><li>A Quality Mental Health Service is one that:- </li></ul></ul><ul><ul><li...
Quality in Mental Health – Your Views <ul><ul><li>Provides a  holistic, seamless service  and encompasses the  full contin...
Quality in Mental Health – Your Views contd. <ul><ul><li>Has  effective management  and  leadership </li></ul></ul><ul><ul...
International MHS common problems/deficiencies <ul><li>A  lack of focus  on  mental health </li></ul><ul><li>Inadequate sy...
Quality Framework (QF)- Scope <ul><li>A framework for continuously improving quality in mental health services in Ireland ...
Standard <ul><li>A broad statement of the desired and achievable level of performance against which actual performance can...
Criteria <ul><li>Measurable elements of service provision </li></ul><ul><li>Relate to desired outcome or performance of st...
Standards  Approach: Strengths <ul><li>Service users/families </li></ul><ul><ul><ul><ul><li>Know what to expect from a MHS...
Standards Approach: Strengths  (contd.) <ul><li>Monitoring </li></ul><ul><ul><ul><ul><li>Transparent mechanism for evaluat...
 
Comparative Analysis:  Vision for Change <ul><ul><li>Themes and standards in QF compared with the </li></ul></ul><ul><ul><...
Framework, standards and associated criteria informed by: <ul><ul><li>“ Mental Health – Your Views” </li></ul></ul><ul><ul...
 
 
 
 
 
Legislative framework to support standards <ul><li>Legislation √ </li></ul><ul><li>Appropriate enforcement  √ </li></ul><u...
Implementation & Sustainability <ul><li>“ For Clinical Improvements to be anything other than a fad, the improvements we m...
System Level Change <ul><li>In order for  reform to succeed changes  must occur at </li></ul><ul><li>all  of the following...
Implementation: <ul><ul><li>Receptive context for change </li></ul></ul><ul><ul><li>Clear plan </li></ul></ul><ul><ul><ul>...
Implementation  Critical Success Factors <ul><li>Attainment of  “buy in” at senior management levels  and  commitment  fro...
THANK YOU <ul><li>www.mhcirl.ie </li></ul>
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Patricia Gilheaney A Standards Approach To Embedding Rights In Mental Health Services The Mhc Quality Framework

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A Standards Approach to Embedding Rights In Mental Health Services the MHC Quality Framework

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  • Patricia Gilheaney A Standards Approach To Embedding Rights In Mental Health Services The Mhc Quality Framework

    1. 1. A Standards Approach to Embedding Rights in Mental Health Services Quality Framework Mental Health Services in Ireland Patricia Gilheaney Director Standards & Quality Assurance
    2. 2. MHC statutory mandate Section 33, Mental Health Act, 2001 <ul><li>“ The principal functions of the Commission shall be to promote , encourage and foster the establishment and maintenance of high standards and good practices in the delivery of mental health services and to take all reasonable steps to protect the interests of persons detained in approved centres under this Act”. </li></ul><ul><li>[Section 33(1)] </li></ul>
    3. 3. MHC statutory mandate Section 33, Mental Health Act, 2001 <ul><li>“ The Commission shall undertake or arrange to have undertaken such activities as it deems appropriate to foster and promote the standards and practices referred to in subsection (1). [Section 33(2) ] </li></ul><ul><li>“ The Commission shall have all such powers as are necessary or expedient for the purposes of its functions.&quot; [Section 33(4)] </li></ul>
    4. 4. Key stages in developing the quality framework for mental health services in Ireland
    5. 5. Quality in Mental Health – Your Views <ul><ul><li>A Quality Mental Health Service is one that:- </li></ul></ul><ul><ul><li>Facilitates respectful and empathetic relationships between people using the service, their families, parents and carers, and those providing it </li></ul></ul><ul><ul><li>Empowers people who use mental health services, and their families, parents and carers </li></ul></ul>
    6. 6. Quality in Mental Health – Your Views <ul><ul><li>Provides a holistic, seamless service and encompasses the full continuum of care </li></ul></ul><ul><ul><li>Is equitable and accessible </li></ul></ul><ul><ul><li>Is provided in a high quality environment , which respects the dignity of the individual, his/her carers and family </li></ul></ul>
    7. 7. Quality in Mental Health – Your Views contd. <ul><ul><li>Has effective management and leadership </li></ul></ul><ul><ul><li>Is delivered by highly skilled multidisciplinary teams </li></ul></ul><ul><ul><li>Is based on best practice and incorporates systems for evaluation and review </li></ul></ul>
    8. 8. International MHS common problems/deficiencies <ul><li>A lack of focus on mental health </li></ul><ul><li>Inadequate system capacity and workforce resources and competencies </li></ul><ul><li>Insufficient involvement of consumers & caregivers in service planning. </li></ul><ul><li>Variability in service provision and in the quality and effectiveness of care provided </li></ul><ul><li>Delays in application of evidence-based practices, quality improvement tools & I.T. </li></ul>
    9. 9. Quality Framework (QF)- Scope <ul><li>A framework for continuously improving quality in mental health services in Ireland </li></ul><ul><li>Q.F. is applicable to all mental health services irrespective of the speciality or whether they are being delivered in: </li></ul><ul><ul><ul><ul><ul><li>Service user’s home </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Community settings </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>In-patient facilities </li></ul></ul></ul></ul></ul><ul><li>Q.F. is flexible: </li></ul><ul><ul><ul><ul><ul><li>Diverse needs of service users </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Different nature and scale of organisation </li></ul></ul></ul></ul></ul><ul><li>Standards are not prescriptive </li></ul>
    10. 10. Standard <ul><li>A broad statement of the desired and achievable level of performance against which actual performance can be measured </li></ul><ul><ul><li>Overall goal </li></ul></ul><ul><ul><li>Outlines the objective that is expected </li></ul></ul><ul><li>Standards in the Q.F. adhere to the International Principles for healthcare standards. </li></ul>
    11. 11. Criteria <ul><li>Measurable elements of service provision </li></ul><ul><li>Relate to desired outcome or performance of staff or services </li></ul><ul><li>Include </li></ul><ul><ul><li>SI 551 of 2006 [Mental Health Act 2001 (Approved Centres) Regulations 2006 </li></ul></ul><ul><ul><li>Rules & Codes of Practice </li></ul></ul><ul><li>Standard is achieved when all associated criteria are met </li></ul><ul><li>RUMBA rule (relevant, understandable, measurable, behaviourally stated & achievable) </li></ul>
    12. 12. Standards Approach: Strengths <ul><li>Service users/families </li></ul><ul><ul><ul><ul><li>Know what to expect from a MHS </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Opportunity for service user feedback at all levels in system </li></ul></ul></ul></ul><ul><li>MHS </li></ul><ul><ul><ul><ul><li>Quality improvement </li></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Standards facilitate self monitoring of performance </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Driver for change – policies/legislation/practice/structures </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Provide consistency </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><li>Development </li></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Focus on results </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Generate real improvements in MHS </li></ul></ul></ul></ul></ul>
    13. 13. Standards Approach: Strengths (contd.) <ul><li>Monitoring </li></ul><ul><ul><ul><ul><li>Transparent mechanism for evaluating quality of MHS provision in Ireland for the first time </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Service users / MHC / service providers </li></ul></ul></ul></ul><ul><li>Profile </li></ul><ul><ul><ul><ul><li>Platform for increasing the profile of mental health </li></ul></ul></ul></ul>
    14. 15. Comparative Analysis: Vision for Change <ul><ul><li>Themes and standards in QF compared with the </li></ul></ul><ul><ul><li>207 Recommendations </li></ul></ul><ul><ul><li>- Highlights the overlap between current Government mental health policy – A Vision for Change & Quality Framework for Mental Health Services in Ireland </li></ul></ul>
    15. 16. Framework, standards and associated criteria informed by: <ul><ul><li>“ Mental Health – Your Views” </li></ul></ul><ul><ul><li>Review of quality frameworks in health systems in other countries </li></ul></ul><ul><ul><li>International principles for healthcare standards </li></ul></ul><ul><ul><li>International experts </li></ul></ul><ul><ul><ul><li>Healthcare quality </li></ul></ul></ul><ul><ul><ul><li>Mental health care services </li></ul></ul></ul><ul><ul><li>Recommendations from </li></ul></ul><ul><ul><ul><li>Commission </li></ul></ul></ul><ul><ul><ul><li>Inspectorate of Mental Health Services </li></ul></ul></ul>
    16. 22. Legislative framework to support standards <ul><li>Legislation √ </li></ul><ul><li>Appropriate enforcement √ </li></ul><ul><li>Panacea? </li></ul><ul><li>What else do we need? </li></ul>
    17. 23. Implementation & Sustainability <ul><li>“ For Clinical Improvements to be anything other than a fad, the improvements we make must be lasting….” </li></ul><ul><li>Langley et al (1996) </li></ul><ul><li>Langly G, Nolan K, Nolan T, Norman C, Provost L. (1996) The Improvement Guide . San francisco: Jossey Bass. </li></ul>
    18. 24. System Level Change <ul><li>In order for reform to succeed changes must occur at </li></ul><ul><li>all of the following 4 levels </li></ul><ul><li>The experiences of individuals, families and communities </li></ul><ul><li>Microsystems of care – the point of patient / health professional interaction </li></ul><ul><li>Larger healthcare organisations and systems </li></ul><ul><li>External environment of care, including policy, financing and legislation / regulation </li></ul>Berwick,2002
    19. 25. Implementation: <ul><ul><li>Receptive context for change </li></ul></ul><ul><ul><li>Clear plan </li></ul></ul><ul><ul><ul><li>Critical success factors </li></ul></ul></ul><ul><ul><ul><li>Achievable specified timeframes </li></ul></ul></ul><ul><ul><ul><li>Multilayered (service user, professional, managerial) </li></ul></ul></ul><ul><ul><ul><li>Provision of infrastructure to facilitate sustainability </li></ul></ul></ul><ul><ul><ul><ul><li>Maintaining improvements in terms of targets </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Sustaining the changes </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Aligning financial systems </li></ul></ul></ul></ul><ul><ul><ul><ul><li>Discontinuing ineffective quality initiatives </li></ul></ul></ul></ul>
    20. 26. Implementation Critical Success Factors <ul><li>Attainment of “buy in” at senior management levels and commitment from all stakeholders to the quality framework </li></ul><ul><li>Provision of appropriate resources in accordance with the costed implementation plan </li></ul><ul><li>Devolved budgets to strengthen accountability and effective resource utilisation </li></ul><ul><li>Effective planning that permeates from the macro / strategic level to the point of service delivery </li></ul><ul><li>Strong leadership at all levels to implement the changes required. </li></ul>
    21. 27. THANK YOU <ul><li>www.mhcirl.ie </li></ul>

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