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Developing an outcome-focused service in Sussex Partnership: introducing the ROMs champion Aryana Shirazi [email protected] Assistant Psychologist - East Kent CAMHS Nicola Vince [email protected] Assistant Psychologist - East Kent CAMHS Eating Disorders Service

In 2014, the role of a Routine Outcome Measures (ROMs) champion was introduced across Kent. A Routine Outcome Measures (ROMs) champion is an appointed Senior Psychologist who acts as the intermediary between the overall ROM lead and the Assistant Psychologists (AP) in different teams. ROM Lead ROM

Champion Assistant Psychologist For example, a ROM champion would: Attend monthly ROMs meetings with their AP and relay important decisions made in the ROM meeting to their team Provide ROM supervision for APs Support in the maintenance of ROMs completion rates in their

team Ensure ROM action plans are implemented within the team The following five routine outcome measures are currently implemented across Kent in the main CAMHS teams: Strengths and Difficulties Questionnaire (SDQ) Revised Childrens Anxiety and Depression Scales (RCADS) Childrens Global Assessment Scale (CGAS) Experience of Service Questionnaire (ESQ) Health of the Nation Outcomes Scales for Children

and Adolescents (HONOSCA) Considering the effectiveness of ROMs champions Impact can vary across teams depending on the availability of staff for the role Different areas/teams can have different procedures therefore the role of ROM champion needs to be adaptive Where ROM champions are in place we have been able to deliver more training to teams ROM champions provide continuity in implementation and

feedback These measures are all given out at initial assessment (Time 1), at 4-8 months after assessment (Time 2), and at case closure. Case Study from West Kent Problem: Since data collection began on outcome measures, we have found poor completion of ROM at T2 and closure.

What we wanted to achieve: Improve clinicians engagement with ROM implementation to increase completion rates. How we did it: Improved clinician's self-efficacy around completing ROMs in session Gave individual feedback of measures already collected to improve confidence and establish trust to improve engagement Outcome: Completion rates improved according to the months we provided

training in team meetings (or at away days). The rates dropped off again in months where we didnt do this. Conclusion: Raising the profile of ROM and keeping a continuous dialogue open around its use and benefits, twinned with data feedback can improve completion rates, but we need to work on the retention of this effect . Parents Experience of Service Questionnaire Word Cloud Young Peoples Experience of Service Questionnaire Word Cloud

Case study from South Kent Problem: We found that clinicians were waiting for young people (YP) and their families to complete or post back ROMs before completing the clinician rated measures (the CGAS and HONOSCA). What we wanted to achieve: We wanted to encourage the completion of CGAS and HONOSCA regardless of whether other ROMs had been posted out, received back, completed in session or refused to be completed.

How we did it: The South Kent ROM champion and AP encouraged regular interrater reliability sessions amongst clinicians after weekly team meetings. Outcome: Since these sessions were introduced, CGAS and HONOSCA rates have stayed around the same as patient measure completion rates. Conclusion: There needs to be further exploration of why clinician rated

measures are still poor. ROM Champion & AP: A collaborative approach In trying to raise the profile for ROMs across the different teams, our regional APs and ROM champions have worked together in empowering our fellow clinicians to implement ROMs. In the Child in Care team, the presence of an AP is a recent phenomena: a ROMs process flowchart was cascaded via e-mail to the team to show the exact

process and responsibility of each team member. ROM clinics were also put in place for staff who wanted support in learning to score and input ROMs on our patient system. Overtime, this has lead to regular use of ROMs across a wider range of clinicians. ROM Champion & AP: A collaborative approach In East Kent, we have started to implement a monthly ROMs update e-mail, to enable the team to see our latest completion rates for each measure.

In addition to this, we have created a checklist pack for clinicians which covers everything they need to implement for their clinical cases. E.g. risk assessments, care plan etc. This pack also includes a ROMs checklist and ROM process flowchart to visually aid clinicians and to encourage automatic ROMs completion. Kent Assistant Psychologists experience of ROMs Champions In our experience, having ROM champions has been a great asset to our Kent wide ROM process. This is especially true in areas where the champion has capacity to be actively involved in the upkeep of

the ROMs improvement plan. From an AP perspective, its highly valuable having someone to reinforce tasks that are asked of clinicians the presence of a ROMs champion works by feeding back the progress of ROMs into local leadership teams. This then creates continuity and consistency in the ROMs process across Kent With thanks to: Jenny Cooke Assistant Psychologist West Kent CAMHS [email protected]

Faiben Yemane Assistant Psychologist South Kent CAMHS [email protected] Kiran Shetra Assistant Psychologist CAMHS Child in Care team Kiran[email protected] and the ROMs and respective clinical teams! Thanks for listening!

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