Wilson Scott, Metcalfe Julie, McLeod Stephen
Specialist Children's Services, NHS Greater Glasgow and Clyde, Glasgow, UK.
Int J Health Care Qual Assur. 2015;28(8):812-25. doi: 10.1108/IJHCQA-03-2015-0032.
The purpose of this paper is to compare NHS Greater Glasgow and Clyde (NHSGGC) Child and Adolescent Mental Health Service (CAMHS) activity data over a one-year period to the Choice and Partnership Approach (CAPA) demand and capacity model assumptions, providing an evaluation of CAPA model implementation and its effects on actual demand and capacity of the service.
DESIGN/METHODOLOGY/APPROACH: Three assumptions within the CAPA model are tested against activity data extracted from the patient management system. Analysis by patient record assesses the number of appointments the patients received and the patients' journey from assessment to treatment. A combination of community CAMHS data are combined to compare actual activity against assumed capacity required to meet demand according to the CAPA model.
Tested against an audit of 2,896 patient records, CAMHS average 7.76 core appointments per patient compared to the CAPA assumption of 7.5 appointments at a 0 per cent DNA rate. The second CAPA assumption states that 66 per cent of assessments will result in treatment, compared to 73.55 per cent in NHSGGC CAMHS. Finally, the workforce model in CAMHS has clinical capacity to meet demand according to the CAPA assumption of weekly accepted referral rates not exceeding the number of clinical whole time equivalent.
ORIGINALITY/VALUE: The data allow for identification of inefficiencies within CAMHS and highlights how capacity can be increased, without increasing budgets, to meet a rising clinical demand. The results allow managers and clinicians to improve job planning to ensure more children and young people have quick access to services.
本文旨在将NHS大格拉斯哥和克莱德地区(NHSGGC)儿童及青少年心理健康服务(CAMHS)在一年期间的活动数据与选择与伙伴关系方法(CAPA)的需求和能力模型假设进行比较,对CAPA模型的实施情况及其对该服务实际需求和能力的影响进行评估。
设计/方法/途径:针对从患者管理系统中提取的活动数据,对CAPA模型中的三个假设进行检验。通过患者记录分析评估患者接受的预约数量以及患者从评估到治疗的过程。将社区CAMHS数据进行整合,以根据CAPA模型将实际活动与满足需求所需的假设能力进行比较。
根据对2896份患者记录的审计,CAMHS患者平均每人有7.76次核心预约,而CAPA假设在零爽约率的情况下为7.5次预约。CAPA的第二个假设称,66%的评估将导致治疗,而NHSGGC CAMHS的这一比例为73.55%。最后,根据CAPA假设每周接受的转诊率不超过临床全职等效数量,CAMHS的劳动力模型具备满足需求的临床能力。
原创性/价值:这些数据有助于识别CAMHS内部的低效率情况,并突出了如何在不增加预算的情况下提高能力以满足不断增长的临床需求。研究结果使管理人员和临床医生能够改进工作计划,以确保更多儿童和年轻人能够快速获得服务。