In September 2015 I had the opportunity to attend the International Initiative for Mental Health Leadership (IIMHL) in Vancouver that included a two day meeting of the Clinical Leaders Group at Columbia University in New York. This group has been meeting for seven years with a focus on identifying a set of indicators that could be used for international benchmarking to inform service improvement and is coordinated by Dr Harold Pincus, Professor of Psychiatry, Columbia University. A number of other New Zealand representatives have attended this meeting in previous years including Robyn Shearer and Mark Smith from Te Pou. The project has occurred in three phases to try and refine the number of KPI’s and the definitions.

The goals of the 2015 meeting were to:

·         Summarise earlier work

·         Do a deeper dive into Phase III Data

·         Get country updates

·         Identify next steps/ projects 

The main challenges have been the complexity of operationalising within and across the differing health systems, with diverse data collection systems and varying indicator definitions – especially for countries with limited Mental Health Informatics availability. The bulk of discussions focused on those measures currently reported by five or more countries. Attempts to reduce the shortlist to a smaller number of KPIs that are consistently collected and defined have been unsuccessful to date and further research will be done on three shortlisted indicators (28 day readmission rate, 7 day follow up and average length of stay).

The Group has also been looking at what outcome and recovery measures are being used across the participating countries (NZ, Australia, England, US, Canada, the Netherlands, Sweden). Our closest allies for future development are Australia and England because of the similarities in our systems and ambitions. 

The next steps identified for the IIMHL Clinical Leaders International Mental Health Indicator Project are:

1.      Short term effort: deep dive benchmarking of  a limited set of measures which focus on inpatient care (target timeline: March 2016)

2.      Long term effort: include deep dives on a broader set of additional candidate measures as proposed by the group (target timeline: IIMHL meeting in Sydney, Spring 2017)

3.      Recovery ontology/ taxonomy

4.      Survey on use of measures

5.      Collaboration with other organisations (i.e. OECD, WHO/Global Mental Health Research Network and others)

At the New York meeting I was able to present an overview of what is happening in NZ on behalf of the KPI Programme and Te Pou. Te Pou continues to contribute data to the project. Since the New York meeting the NHS Benchmarking Network team in the UK have been in touch to progress the “deep dive” work for a shortlist of high value indicators so we will be continuing our involvement over the coming months.

I very much enjoyed participating in the meeting although the focus of the discussions was strongly academic rather than operational. New Zealand is performing well internationally in terms of infrastructure and investment in informatics and benchmarking and it reminded me how crucial this support is in order to foster an environment of transparency for the purpose of growth and improvement.







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