A comparison of parent reported outcome with experience of services

Date20 June 2016
Published date20 June 2016
AuthorShelley Marie Norman,Tamsin Ford,William Henley,Robert Goodman
A comparison of parent reported outcome
with experience of services
Shelley Marie Norman, Tamsin Ford, William Henley and Robert Goodman
Shelley Marie Norman is an
Associate Research Fellow at
the Child Health Group,
University of Exeter Medical
School, Exeter, UK.
Tamsin Ford is a Professor of
Child and Adolescent
Psychiatry at the Institute of
Child Health, University of
Exeter Medical School,
Exeter, UK.
William Henley is a Professor of
Medical Studies at the Institute
of Health Research, University
of Exeter Medical School,
Exeter, UK.
Robert Goodman is a
Professor at the Institute of
Psychiatry, Psychology and
Neuroscience, Kings College
London, London, UK.
Purpose Routine outcome monitoring (ROM) is currently seen as a key driver for service improvement at
individual, team and service level. The purpose this paper is to explore the relationships between a patient
(parent) reported outcome measure (PROM), a practitioner reported outcome measure, and a patient
(parent) reported experience measure (PREM).
Design/methodology/approach A cohort of 302 primary school-age children was recruited and followed
for one year from consecutively accepted referrals to three teams within two English Child and Adolescent
Mental Health Services (CAMHS). Parents completed the Strengths and Difficulties Questionnaire (a PROM)
and practitioners completed the Clinician Global Assessment Scale at baseline, six and 12 months; parents
completed the Experience of Services Questionnaire (a PREM) at six and 12 months.
Findings PROM and practitioner rep orted outcome measure data suggested poor clinica l outcome in
terms of symptoms, impact and levels of functioning but were accompanied by PREM evidence of high
levels of satisfaction. There was an unexpectedly low correlation (o0.2) between both meas ures of
outcome and satisfacti on.
Originality/value This paper fulfils a need to explore the relationships between different outcome
measures to contribute to the understanding of ROM its validity.
Keywords Satisfaction, Outcome measures, CAMHS, PREMs, PROMs, Routine outcome monitoring,
Service-user satisfaction, ROM
Paper type Research paper
Policy makers and commissioners recommend routine outcome monitoring (ROM) as a key
method for quality assurance (Department of Health, 2010). ROM can support good practice
and innovation while highlighting areas of difficulty at an individual, practitioner, team or service
level, particularly for areas where the evidence base is sparse (Kazdin, 2008). The publication of
routinely collected data on post-operative mortality in cardiac surgery may have contributed to a
reduction in post-operative mortality (Bridgewater et al., 2007). However, the chronic and
fluctuating nature of psychopathology, the need for multiple informants and the impact of school,
home and other environments beyond the control of Child and Adolescent Mental Health Service
(CAMHS) interventions make the use of ROM particularly complex in relation to childrens mental
health. The use of standardised outcome measures in any health specialty, however, is also not
without controversy, in terms of the availability of appropriately sensitive and focused measures,
as well as the potential but yet to be demonstrated influence of case complexity (Bridgewater
et al., 2007; Norman, 2011; Yates et al., 1999). However, in the current economic and policy
climate, CAMHS need to be able to demonstrate that the interventions offered have had an
impact, and the use of ROM is a major part of the Children and Young Peoples Increased
Access to Psychological Therapy programme (IAPT) (Wolpert et al., 2012a).
Received 2 April 2015
Revised 29 October 2015
Accepted 13 November 2015
DOI 10.1108/JCS-04-2015-0015 VOL. 11 NO. 2 2016, pp. 157-169, © Emerald Group Publishing Limited, ISSN 1746-6660
PAG E 15 7

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