audit project child and adolescent psychiatry southmead camhs

18
AUDIT PROJECT CHILD AND ADOLESCENT PSYCHIATRY SOUTHMEAD CAMHS “Choice to Partnership transition in CAPA process” Caroline Fell 27 th January 2010

Upload: duman

Post on 12-Feb-2016

35 views

Category:

Documents


0 download

DESCRIPTION

Audit Project Child and Adolescent Psychiatry Southmead CAMHS. “Choice to Partnership transition in CAPA process” Caroline Fell 27 th January 2010. “ choice & partnership approach ” background Information. 1 st evolved in Richmond CAMHS, later developed and implemented in East Herts CAMHS - PowerPoint PPT Presentation

TRANSCRIPT

Page 1: Audit Project Child and Adolescent  Psychiatry Southmead  CAMHS

AUDIT PROJECTCHILD AND ADOLESCENT PSYCHIATRYSOUTHMEAD CAMHS

“Choice to Partnership transition in CAPA process”

Caroline Fell27th January 2010

Page 2: Audit Project Child and Adolescent  Psychiatry Southmead  CAMHS

“CHOICE & PARTNERSHIP APPROACH”BACKGROUND INFORMATION

1st evolved in Richmond CAMHS, later developed and implemented in East Herts CAMHS

Now used in many CAMHS across the UK North west Bristol CAMHS for **yrs

CAPA This is a whole clinical system from the

beginning of the family’s journey to the end Referral choice partnership + specialist

Page 3: Audit Project Child and Adolescent  Psychiatry Southmead  CAMHS

Choice Children and families making informed choices

about what services & interventions may be useful to them

Focus on engagement We should facilitate this using our expertise

We should facilitate conversational curiosity that draws on their strengths

How can the family and young person help themselves between choice and partnership appointments

Reach a “choice point” Partnership appointment booked at the end of the choice

appointment with a clinician/s with the best skills to help

Page 4: Audit Project Child and Adolescent  Psychiatry Southmead  CAMHS

Important aspect to CAPA is choosing the partnership clinician

1. It affects the family and therapist position to the Choice by facilitating choice completion, engagement with “change not clinician” and gives family autonomy in their choice2. It affects the Partnership Appointment by starting with the “right” therapist with the “right” skills3. It helps plan and manage your teams capacity

Core treatment skills of partnership clinicians (ABCDS) Assessment Behavioural Cognitive Dynamic Systemic

Page 5: Audit Project Child and Adolescent  Psychiatry Southmead  CAMHS

COHORT Questionnaire to all choice clinicians 3/12 period Those progressing to partnership

Total 17 completed 2 straight to specialist work

Page 6: Audit Project Child and Adolescent  Psychiatry Southmead  CAMHS

THE QUESTIONS......1. Has the work or intervention that you feel to be necessary

for this YP/family been discussed with them at the choice appointment?

2. Was the YP/family asked what skills or “personality traits” they would like in their partnership clinician?

3. Does your YP/family know of the change in clinician for their partnership appointment at the end of today’s meeting?

4. Why did you choose the specific clinician that you have assigned for partnership work with this YP/family?

5. Are you aware of the core work and specialist work that this specific clinician can offer? Please specify a) core skills b) specialist skills

6. How quickly will your YP/family be seen in a partnership appointment?

7. Is there anything that you wish was different to ease the transfer of the YP/family from choice to partnership?

Page 7: Audit Project Child and Adolescent  Psychiatry Southmead  CAMHS

RESULTS1. Has the work or intervention that you feel to be necessary for this YP/family been discussed with them at the choice appointment?

15 out of 17 “yes” 2 were “briefly” i.e. Introduced to some ideas

and possibilities 1 was “no”

Needed to discuss at team meeting before decision could be made

? Group supervision at choice clinics

Page 8: Audit Project Child and Adolescent  Psychiatry Southmead  CAMHS

2. Was the YP/family asked what skills or “personality traits” they would like in their partnership clinician?

9 out of 17 “yes” 8 out of 17 “no”

“based on clinical needs” “not relevant” 2 were put straight into specialist work

Page 9: Audit Project Child and Adolescent  Psychiatry Southmead  CAMHS

3. Does your YP/family know of the change in clinician for their partnership appointment at the end of today’s meeting?

13 out of 17 “yes” 2 that were “no” went straight from choice

clinician to specialist work with same clinician

1 other kept same clinician as had seen child in school previously

1 other had been completing a joint choice, and continued the work in partnership

Page 10: Audit Project Child and Adolescent  Psychiatry Southmead  CAMHS

4. Why did you choose the specific clinician that you have assigned for partnership work with this YP/family?

14 out of 17 stated clinical skills 3 out of 17 stated availability 1 out of 17 stated sex of clinician 1 out of 17 was due to working with clinician

before 2 out of 17 gave no reason

Page 11: Audit Project Child and Adolescent  Psychiatry Southmead  CAMHS

5. Are you aware of the core work and specialist work that this specific clinician can offer? Please specify a) core skills b) specialist skills

Core skills “all” A 9, B6, C6, D7, S6 4 “no/ unknown” or left out as went straight to

specialist Specialist skills

All appropriate

Page 12: Audit Project Child and Adolescent  Psychiatry Southmead  CAMHS

6. How quickly will your YP/family be seen in a partnership appointment?

Page 13: Audit Project Child and Adolescent  Psychiatry Southmead  CAMHS

7. Is there anything that you wish was different to ease the transfer of the YP/family from choice to partnership?

“sooner appointments in partnership” “more partnership appointments” “partnership appointments in the diary”

Page 14: Audit Project Child and Adolescent  Psychiatry Southmead  CAMHS

AUDIT CYCLESet standards

measure practicecompare against practiceidentify improvements?suggest &implement changes (to improve clinical care)evaluate and review those changesre-audit

Page 15: Audit Project Child and Adolescent  Psychiatry Southmead  CAMHS

COMPARISONS & IMPROVEMENTS

- Ethos of choice partnership preserved

- Facilitation of informed choice re. needs and not “prescribing”

- Change clinician- Core skills of

partnership clinician- Specialist skills

seemed appropriate when stated

- Majority seen in partnership within 4 weeks

- Time- Lack of partnerships in diary- Sooner appointments

- Skills of clinicians ??- 2 questionnaires stated did

not know one or other of core & specialist skills

- 3 chose the partnership clinician due to availablity (2 stated nothing) ? Correct match of clinical skills for that family

- Asking what skills the family would want (informed choice if they agree on clinical need?)

Page 16: Audit Project Child and Adolescent  Psychiatry Southmead  CAMHS

IMPROVEMENTS VERY LITTLE!

Partnership appointments in advance for all team members Time (?!) Updated quarterly and then can opt out?

Information re. team members skills “skill profile” may help and improve discussion of

clinicians skills to families/ young people at choice ABCDS ? Attached to partnership diary

Page 17: Audit Project Child and Adolescent  Psychiatry Southmead  CAMHS

CHANGES TO RE-AUDIT Team to have partnership appointments for

the next quarter put in the diary by administrative staff. Clinicians responsibility to change them if necessary

Team “skill profile” to be created and knowledge of all clinicians A,B,C,D and S to be understood

Educate entire team re. general principles of CAPA and findings of the audit

Page 18: Audit Project Child and Adolescent  Psychiatry Southmead  CAMHS

?Any questions or feedback