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Transcript of © Triangle Consulting 2011 1 T The Outcomes Star Hotspot for SIAA Conference Berlin, November 2012...
© Triangle Consulting 2011 1
T
The Outcomes Star
Hotspot for SIAA ConferenceBerlin, November 2012
Joy MacKeith
The Outcomes Star™
Tailored versions for different groups
More in the pipeline
Carers StarCarers StarChildren’s StarChildren’s StarRecovery Star (secure settings)Recovery Star (secure settings)
And in discussion…..And in discussion…..ADHD StarADHD StarOffenders StarOffenders StarEarly Intervention StarEarly Intervention Star
Widely recognised in the UK
Department of Health mental health White Paper ‘New Horizons’ features the Recovery Star. DoH has funded the use of the mental health version of the Star in five of the ten strategic health authorities in England and the new Well-being Star
National membership bodies Homeless Link, Mental Health Providers Forum and Alcohol Concern publish and promote the version for their sector
Local Authorities including Camden, Kirklees, Westminster and Derbyshire are writing the Outcomes Star into their contracts
Chartered Institute of Housing is featuring the Homelessness Star in its new qualification for key-workers in homelessness services
Big Lottery funded the development of the Outcomes Star website Service providers are using it in USA, Australia, Italy, Denmark as
well as UK
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Used around the world
Collaborators offering Stars in the following countriesAustraliaNew ZealandCanadaIrelandFranceItalyHollandDenmark
A visual tool
An objective tool
Detailed descriptions of each scale point
Built on a model of change
Discuss each area in turn
Then plot on Star for overview
Repeat at later point to see change
Notes provide more detailed information
And links directly to action planning
Integrated within case-work
Open discussionof each
area
Agree whereclient is on
their journey in that area
Plot on the star and take an overview
Decide whereto focus and
developaction plan
Triangle Consulting Social Enterprise 2012
Outcomes info at four levels17
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Service outcomes
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Service outcomes (detail)
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Service outcomes as Star
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Service outcomes (detail)
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Compare services
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Compare services (detail)
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Benchmark externally
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Benchmark externally (detail)
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Advanced Service Report
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Advanced Service Report
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Data is easy to interpret28
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Score Interpretation
Mean score on entry to the service = 3.5
entering the service at the ‘Aware’ stageWill attend appointments but need high level of encouragement, supervision and monitoring
Mean score on exit = 6 Leaving the service at the ‘Trying’ stage. Clients are trying to do things differently but still need a lot of support
St Mungos learning from Star data
73% of clients benefit (11% staying stable & 62% progressing)
Best outcomes among a minority group with specialist workers (86% made progress) – demonstrating that this approach works
Women did not progress in the hostels – need to rethink provision for women or avoid hostels?
Outcomes reduce after 12 months, especially without progression and activities in a hostel – need for move-on accommodation
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Resources to support each version
Star online - Flexible use
Can be used on its own or linked via API to an existing system
Works on Ipad and Iphone
Can complete Stars on paper and enter info online afterwards if preferred
Can be purchased as part of a package (eg Substance Views)
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Service users like it
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“I felt fully involved; it was clear and easy to understand and focused on me as a whole person, not just as a problem. It felt like a conversation; felt like the first time someone had really listened to me...”
And so do workers and managers
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“The services are more client-focussed because the Star makes us think about the client and what is changing for each individual.....
It has helped staff to start thinking creatively about how to get greater improvements as well.
Outcomes Stakeholders
Service users need: Tools which empower them to make changes
Workers need: tools which help them work effectively with stakeholders
Managers need: tools which help them identify service strengths and weaknesses
Commissioners need: tools which enable them to identify effective providers
Researchers and policy makers need: tools which help establish which interventions are most effective
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Validation Questions?35
Service Users – lots of case study evidence
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“I felt fully involved; it was clear and easy to understand and focused on me as a whole person, not just as a problem. It felt like a conversation; felt like the first time someone had really listened to me...”
A Mental Health Tribunal
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The RMO spoke of the Recovery Star and how her team uses it tool with patients..... The sense of progressive momentum and optimism that seems to be possible with this tool is just so lovely to hear about, and such a privilege to see in action. This was a lad who could so easily have gone on to be crippled with such early psychotic distress, but instead seems to be facing an energised sense of his own capabilities
Workers
1) Burns, MacKeith and Graham (2008) Looked at 25 organisations that had been using the homelessness version of the Outcomes Star for two years or more
All 25 organisations reported that key-work had improved as a result of using the Outcomes Star
Key-work had become more focused on service user change more systematic and consistent and covered a wider range of issues
2) Study carried out by the University of Newcastle and Hunter New England Mental Health, Australia on the Recovery Star found that clinicians viewed all Recovery Star domains as important for care planning
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And lots of case study evidence too
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“The services are more client-focussed because the Star makes us think about the client and what is changing for each individual.....
It has helped staff to start thinking creatively about how to get greater improvements as well.
Outcomes data for Managers (from St Mungos research)
73% of clients benefit (11% staying stable & 62% progressing)
Most progress seen in accommodation and substance misuse, least in living skills and mental health
Only 46% of women make progressBest outcomes among a minority group with
specialist workers – 86%Positive outcomes correlate with participation in
activities in the project and outings
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Many commissioners are writing the Star into their contracts and are requiring reporting on Star data – in some cases as part of PbR contracts (in Supporting People)
We recommend that Star data is collected alongside severity and risk data
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Commissioners:
Policy-makers and Researchers
Two studies carried out on the Recovery Star1)Study carried out by Mental Health Providers Forum and St Andrews “Recovery Star: validating user recovery” published in 2012 in the Psychiatrist
2)Study carried out by Dr Helen Killaspy at University College Hospital, London, submitted for publication
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MHPF and St Andrews Study
Based on 2 Star readings for 203 service users
Normal distribution: Scores on 7 of 10 scales were normally distributed
Internal consistency: highItem redundancy: lowResponsiveness (ie the tool recorded change over
time): Good
Study indicated some refinement needed on Addictive behaviour, responsibilities and work scales
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UCL Study
Based on Star readings with 172 services users and 120 staff from four inpatient and community services participated.
Test:retest reliabilityInter-rater reliabilityConvergent validityWorker views of usefulness and usabillityService user views of usefulness and usability
Some issues with suitability of some of the settings
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© Triangle Consulting 2012
To find out more
Visit www.outcomesstar.org.uk to find out more about the Outcomes Star and download and try out paper versions of the Star for free
Visit www.staronline.org.uk and click on 30 day free trial to experiment with using the Star online yourself
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