A clinical database for measuring outcomes in a low-secure service: a feasibility study
| Date | 04 February 2014 |
| Published date | 04 February 2014 |
| Pages | 58-67 |
| DOI | https://doi.org/10.1108/JFP-08-2012-0006 |
| Author | Rachel Edworthy,Najat Khalifa |
| Subject Matter | Health & social care,Criminology & forensic psychology,Forensic practice |
A clinical database for measuring
outcomes in a low-secure service:
a feasibility study
Rachel Edworthy and Najat Khalifa
Rachel Edworthy is an Audit
and Research Assistant and
Dr Najat Khalifa is a Consultant
Forensic Psychiatrist, both are
based at Nottinghamshire
Healthcare NHS Trust,
Nottingham, UK.
Abstract
Purpose – The purpose of this paper is to present the arguments for sustaining a clinical database, assess
its feasibility in a low-secure service, examine the data that can be captured and discuss what this means for
practice implications and service development. The paper aims to demonstrate how a clinical database can
provide information on three key areas: what patients are like before admission, what is done with them
whilst they are in hospital and what happens to them when they are discharged. The paper also aims to
examine the practical, legal and ethical implications of building such a database.
Design/methodology/approach – This is conducted in the form of a feasibility study charting the
development and implementation of an inpatient clinical database for a low-secure inpatient service.
Findings – The feasibility of creating and maintaining a clinical database in a low-secure service has been
assessed and the paper has found that they are an invaluable source of data that all mental health services
should strive to develop. They will enable services to track their own outcome measures and tailor their
service and interventions according to the needs of service users. However, ethical and legal issues
surrounding building clinical databases are complex and require careful consideration.
Research limitations/implications – This is a small-scale study that captured the experience of one
service. Ideally this research should be expanded with nationwide clinical database development.
Practical implications – This paper includes implications for the implementation of a clinical database,
the resources needed for the running of this and the development of standardised outcome measures for
mental health services.
Originality/value – This is potentially an innovative way of developing a clinical database for a low-secure
unit and some of the first research into the feasibility of a database for this population. Its practical
application is relatively new and potentially innovative in how it is applied.
Keywords Case register, Clinical database, Low secure, Outcome measures
Paper type Case study
Introduction
Producing positive healthcare outcomes and improving the lives of patients are top priorities for
both healthcare professionals and providers alike. Because of this, it can be argued that any
mechanism that can be used to measure improvements to patient well-being should be utilised
effectively.This is where the value of acomprehensive, centralised clinical databasecan trulybe
felt. First it is important to define what is meant by a clinical database. According to Pryor et al.
(1985), “A clinical database is created when well-defined, discrete and continuous data
elements concerning patients are routinely recorded and coupled with outcome descriptors”.
Recent government initiatives have provided the impetus for developing clinical databases.
For instance, the Department of Health has been examining the feasibility of developing
a national, patient-based system for the collection of clinical data on patients in specialist mental
health services for some time (Glover, 2000). Similarly the Council of the European Union has
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JOURNAL OF FORENSIC PRACTICE
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VOL. 16 NO. 1 2014, pp. 58-67, CEmerald Group Publishing Limited, ISSN 2050-8794 DOI 10.1108/JFP-08-2012-0006
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