Safety and Quality in Victoria's Specialist Public Mental Health System

Consumer and carer experience of care and support
- a mental health quality improvement initiative

The C&C Experience is an initiative to find out consumers’ and carers’ experience of care and support while using mental health services based on the issues that consumers and carers have identified as important. The C&C Experience enhances opportunities for consumer and carer participation in service quality improvement. Building on the recommendations of the Review of the 2003-2004 Victorian Survey, the project incorporates new ways of collecting information about experience of care, of feeding it back to staff and participants, and of facilitating consumer and carer involvement in service quality improvement.

• Key features of new approach
• Participating Services 2006-08
• Aims
• Objectives
• Governance Structures
• Pilot Process Flowchart
  • Who can take part?
  • Development Phase
  • Implementation Phase
  • Analysis and Reporting Phase
  • Quality Improvement Phase
• Evaluation
• Bulletins
• Historical Activities/Project

Funded by the Department of Human Services, this project is a collaboration between Victorian Mental Illness Awareness Council, the Network for Carers of people with a mental illness, mental health services and the department. The project commenced in mid 2006 and is anticipated to conclude in June 2008.

To find out more about VMIAC visit their website: www.vmiac.com.au

To find out more about the Network for Carers visit their website:www.carersnetwork.org

Key features of the new approach

C & C Experience Program Logic (PDF File 200KB)

Participating Services 2006-2008

Pilot sites from both clinical and PDRSS sectors have self-nominated to be involved with a selection of eight pilot sites covering rural and metro regions across CAMHS, Adult and Aged Persons including:

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Aims

To create opportunities for consumers and carers to work as partners with mental health services and DHS to provide experience-based information and to support quality improvement processes. This will occur by:

1. Improving the systematic collection, analysis and use of information about consumer and carer experience of mental health services in Victoria

2. Further integrating evaluation of consumer and carer experience of mental health services within broader quality monitoring and improvement frameworks at service level

Objectives

The project will:

• Develop communication and partnerships between consumers, carers, service providers and the Department to promote shared ownership, commitment and involvement
• Improve measures and processes for systematically collecting valid, reliable, appropriate and timely information about consumer and carer experience of mental health services
• Improve reporting and use of information about consumer and carer experience to contribute to service planning, continuous quality improvement and public accountability

Governance Structures

Governance for the project is through a statewide reference group that has representation from the Department, pilot sites, peak bodies, project teams and consumer and carer academic experts. Other committees and working groups assist the reference group by providing reports, guidance and policy direction to the group. Two project teams, one made up of consumers (through VMIAC), and one representing carers (through The Network), have been contracted to collaborate with DHS and services on the project. Health Issues Centre provides training and support to consumer and carer project teams.

C & C Experience Governance Structure (PDF File 42KB)

C & C Experince Stakeholder Relationships Chart (PDF File 80KB)

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Pilot process flowchart

C & C Experience Pilot Process Flowchart (PDF File 88KB)

The above flowchart details the activities in the four phases of the pilot including:

1. Development
2. Implementation
3. Analysis and reporting
4. Quality improvement

The Implementation Phase will start early 2008.

Who can take part?

Development Phase - 2007

Consumers and carers were approached through general publicity at each of the participating services. Any interested consumers and carers were encouraged to be involved in the Development Phase of the project.  The following flyers and information sheets were available for the discussion group in the development phase of the project:

Information Flyers

Carers, we want to hear from you (PDF file 106KB) - December 2006

Consumers, we want to hear from you (PDF file 108KB) - December 2006

Parents / Guardians, we want to hear from you (PDF file 106KB) - January 2007

Information Sheet

Information sheet for discussion group participants (PDF file 108KB) - December 2006

Implementation Phase - 2008

Service staff are being asked to take every opportunity to check that the service’s database is accurate and up-to-date with their consumer and carer contact details. This step is vital to ensure that consumer and carer participation is optimised.  Once the contact details are processed, the CATI operator will send out letters to a randomly selected sample of consumers and carers from each service, informing them about the project and inviting them to take part. Participation is of course voluntary and confidential.

Those consumers and carers who have received an introductory letter can then expect a phone call from a CATI operator asking them if they would like to take part in a short phone interview. It should take around 15 minutes.  Interpreters may also be available. If a consumer or carer would rather complete the questionnaire in hard copy, they will be able to ask for it to be sent out to them with a reply-paid envelope.

Those who choose to answer questions in the phone interview will then be offered the opportunity to register their interest in taking part in a follow-up individual interview or focus group. Participants will be selected from this list.

All participants will be offered the opportunity to have a summary of findings sent to them in recognition of their contribution.

The table below presents an overview of the approximate numbers of consumers and carers involved at each service for the various components of the data gathering phase of the project. The numbers listed below are estimations of what is required to enable psychometric analysis.  Psychometric analysis refers to the application of an appropriate set of statistical techniques to establish the measurement properties of the scales under examination, and to identify the extent to which they comply with acceptable international standards (e.g., pertaining to areas such as reliability, validity etc).  Note that larger numbers will be needed at CAMHS and Aged Services because there are only two of each of these services participating in the pilot, compared to four Adult and four PDRS Services.  It is important to acknowledge that there may be limited access to carers in PDRSS.

A3 C & C Experience Poster - CAMHS (PDF File 138KB)

A3 C & C Experience Poster - Adult, Aged, PDRSS (PDF File 138KB)

C& C Experience Brochure (PDF File 240KB)

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Analysis and Reporting Phase

Findings from the initiative will be posted here. Watch this space!

Quality Improvement Phase – Ongoing commencing in 2008

While only a selected number of consumers and carers can participate in the Implementation Phase, everyone is encouraged to contribute to the ensuing quality improvement activities at their service. Contact your local consumer/carer consultant or key worker if you would like to find out more.

Project and Service Impact

Improving consumer and carer experience of mental health services is one of the most important aspects of quality of care and support. Feedback from consumers and carers is integral to achieving some of the objectives set out in the National Mental Health Information Priorities - www.mentalhealth.gov.au.

This pilot models best practice in collaboration between consumers, carers and staff to improve the experience of care and support provided by mental health services. There are a number of anticipated impacts and opportunities for participating mental health services, and they are outlined below.

Services will be able to demonstrate evidence of best practice in their commitment to understanding and improving the experience of consumers and carers while in clinical and support services.

Services will also be able to build on established collaborative strategies that support:

• staff engagement in reflection on opportunities to improve the quality of mental health services
• consumers, carers and staff collaboration in experience based co-design of services
• reviews of care and support that are specifically targeted and are of importance to consumers, carers and staff
• reviews of the local quality consumer and carer participation plans to better improve outcomes for consumer and carers.

Evaluation

The C&C Experience is articulated in the program logic, which outlines the values, inputs, activities, outputs, outcomes and anticipated impacts of the pilot. 

C & C Experience Program Logic (PDF File 200KB)

The project will be evaluated in terms of both its outcomes and processes.

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Bulletins

Bulletins are designed for staff at participating sites and sent electronically to piot site representatives for dissemination.

15. May 2008 (PDF File 483KB)

14. April 2008 (PDF File 144KB)

13. March 2008 (PDF File 106KB)

12. February 2008 (PDF File 137KB)

11. December 2007 (PDF File 119KB)

10. November 2007 (PDF File 134KB)

9. October 2007 (PDF File 224KB)

8. July 2007 (PDF File 141KB)

7. June 2007 (PDF File 141KB)

6. April 2007 (PDF File 144KB)

5. March 2007 (PDF File 115KB)

4. February 2007 (PDF File 113KB)

3. January 2007 (PDF File 113KB)

2. December 2006 (PDF File 113KB)

1. November 2006 (PDF File 114KB)

Historical Activities/Projects

Surveys of consumer and carer experience of public area mental health services

Victoria has led the way nationally in the development of statewide consumer & carer satisfaction surveys in mental health services.  Consumer and carer satisfaction in child and adolescent, adult and aged persons mental health services has been measured and reported annually from 1997 to 2000.  Under the 2nd National Mental Health Plan 1998-2003, Victoria received funding for projects to further develop its statewide consumer and carer surveys.

A new survey of consumer and carer experience was developed in 2001-02 and implemented during 2003-04.  Surveys of consumer and carer experience in PDRSS were then adapted from those developed for area mental health services in consultation with the PDRSS sector and then piloted during 2003. 

The survey questions reflect consumer and carer identified priorities, needs and expectations of services, and are linked to the National Standards for Mental Health to provide specific guidance for quality improvement and meaningful benchmarks for consumers, carers and service providers.

Consumer and Carer Surveys - Service Reports

Review of the 2003-04 Victorian surveys of consumer and carer experience of public mental health services

The review of the 2003-04 survey has identified a number of opportunities for improving the design and implementation of statewide consumer and carer surveys in mental health. Recommendations for future approaches are detailed in the attached report.

Review of the 2003-04 Victorian surveys of consumer and carer experience of public mental health services - August 2005 (PDF file 703KB)

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