These are our current Adult stream indicators. Click on any indicator to view the data dashboards or read more about the technical definitions.
Please note – The Adult stream are continually reviewing their indicators and will be building further data dashboards in consultation with the sector. Please contact the KPI Programme team if you have any questions or would like to contribute to the development of indicators for this stream.
Seclusion indicators by 100,000 population and per 1,000 bednights
Tāngata whai ora with recorded NGO activity in the 28 days before an inpatient stay
Percentage of tāngata whai ora, who experience an in-scope activity, also had a whānau engagement activity recorded
Percentage of overnight discharges from the mental health and addiction service organisation’s inpatient unit(s) where a community service contact was recorded in the seven days immediately following that discharge.
This KPI calculates an overall follow up rate, which is the percentage of all acute inpatient discharges that were followed up, regardless of where that follow up occurred (DHB, NGO or both)
A responsive community support system for persons who have experienced an acute psychiatric episode requiring hospitalisation is essential to maintain clinical and functional stability and to minimise the need for hospital readmission.
Service users leaving hospital after a psychiatric admission with a formal discharge plan, involving linkages with community services and supports, are less likely to need early readmission. Research indicates that service users have increased vulnerability immediately following discharge, including higher risk for suicide.
Count of acute inpatient discharges
Count of acute inpatient discharges where a follow up community contact (for the same person) exists where:
Community follow-up activity start date is between 1 and 7 days after acute inpatient discharge date
Note: as of November 2020 terminology has changed from ReferralClosureDate to InpatientDischargeDate to eliminate confusion.
This denominator is shared with the other members of the acute inpatient KPI suite: 28-day readmission, length of stay, and pre-admission community contact.
An acute inpatient discharge is any referral record where:
An inpatient discharge date is calculated as the:
A community contact is any activity record where:
Percentage of overnight discharges from the mental health and addiction service organisation’s acute inpatient unit(s) that result in readmission within 28 days of discharge.
This KPI calculates an overall readmission rate, which is the percentage of all acute inpatient discharges that were readmitted, regardless of where that readmission occurred (same DHB or different DHB)
Psychiatric inpatient services aim to provide treatment that enables individuals to return to the community as soon as possible. Unplanned admissions to a psychiatric facility following a recent discharge may indicate that inpatient treatment was either incomplete or ineffective, or that follow-up care was inadequate to maintain the person out of hospital.
Count of acute inpatient discharges
Count of acute inpatient discharges where a readmission occurs within 28 days; that is where an activity exists (for the same person), where:
This denominator is shared with the other members of the acute inpatient KPI suite: 7-day follow-up, length of stay, and pre-admission community contact.
An acute inpatient discharge is any referral record where:
PRIMHD and StatsNZ population projections
A seclusion activity has:
and is recorded against a referral with:
A bednight activity (for the purposes of the seclusion KPI) has:
A bednight is:
Total # bednights (sometimes seen as beddays) is the distinct count of bednights between the reporting start and end date. Where a single bednight activity crosses multiple reporting periods, only the individual bednights within the reporting period are counted.
For example, a bednight activity with start date of 2019-12-20 18:00 and end date of 2020-01-13 09:00 would have 11 bednights counted in the Oct-Dec19 quarter and 13 bednights counted in the Jan-Mar20 quarter.
Population = sourced from StatsNZ, DHB projection for the reporting period
Seclusion activities are sometimes recorded differently due to varying business processes. To accommodate this, we create seclusion events or seclusion episodes in line with Ministry of Health recommendations.
Where there are fewer than 60 minutes between seclusion activities (for the same person and the same referral), these activities are rolled up into a single seclusion event.
A seclusion event combines overlapping or adjacent seclusion activities for an individual tangata whai ora within a single referral.
Total # seclusion events = distinct count of seclusion events where the seclusion event start date falls within the reporting period.
# tāngata whai ora secluded = distinct count of tāngata whai ora with a seclusion event where the seclusion event start date falls within the reporting period.
Seclusion events per 1000 bednights = Total # seclusion events / (Total # bednights / 1,000)
Seclusion events per 100k population = Total # seclusion events / (Population / 100,000)
Seclusion tāngata whai ora per 100k population = # tāngata whai ora secluded / (Population / 100,000)
Hours seclusion = sum of the hours of T33 seclusion activity that occur within the reporting period. When a single seclusion event crosses multiple reporting periods, only the hours within the reporting period are counted.
For example, a seclusion event with start date of 2019-12-28 18:00 and end date of 2020-01-02 09:00 would have 78 hours counted in the Oct-Dec19 quarter and 33 hours counted in the Jan-Mar20 quarter.
Seclusion events are allocated to a shift based on the seclusion event start time:
Likewise, seclusion events are allocated to a weekday based on the seclusion event start date.
Note the fundamental distinction between seclusion events, which are allocated to a reporting period based on their start date, and seclusion hours and bednights, which are broken apart when they cross reporting boundaries and then apportioned pro rata. There are variations in these definition across the sector, so if you observe seclusion numbers that are close but not identical, this date logic may be a good place to check first.
Forensic seclusion events are summarised in a separate report. All forensic seclusion events and bednights are excluded from the national and DHB overviews.
‘Continuity of care’ as indicated through NGO engagement before, during and after acute inpatient DHB stays.
The indicator is a measure to support services understand continuity of care between DHB and NGO mental health services so they can identify where improvement is required to contribute to better wellbeing outcomes for tāngata whai ora who access acute inpatient DHB services.
The indicator includes data for tāngata whai ora with recorded NGO activity in the 28 days before an acute inpatient stay.
Tāngata whai ora report inconsistencies in the connectedness, or continuity of care they receive between DHB and NGO mental health services.
Open NGO referral at time of admission to inpatient unit.
Referral Start Date at least one day before, Referral End Date at least one day after an inpatient stay.
Activity pre inpatient – 1 to 28 days before inpatient admission.
Activity within inpatient stay – inpatient admission to discharge date.
Activity post community care – 1 to 8 days after inpatient discharge.
Meet the criteria for post discharge community care (7-day follow up).
‘Referral from’ is not psychiatric inpatient (PI).
Percentage of tāngata whai ora with whānau engagement
First whānau engagement activity in episode of care
The process of service episode reconstruction is as follows:
1. Exclude any out of scope referrals, which are referrals where contact is not necessarily expected. These are any referrals that meet any of these criteria:
2. Within each unique combination of tangata whai ora and organisation, combine all overlapping in scope referrals into service episodes. This can be achieved in various ways, but the KPI programme uses a ‘gaps and islands’ approach:
3. Within each service episode identify the earliest in scope activity on any referral in the service episode
4. Find the first whānau engagement datetime activity
5. Calculate additional service episode metadata for use in analysis:
6. Calculate the difference between the First in Scope Activity Start Datetime and first whānau engagement datetime. For each episode group as follows
7. Exclude initial team type
8. Only include episodes with a third in scope activity.
Adult stream leads represent our sector contributors and work alongside the KPI Programme team to deliver sector events and guide continuous improvement initiatives. Get to know our current stream leads.
Director Community Mental Health and Addiction Service - Waikato DHBView full profile
Mental Health and Addiction Peer support, education, advocacy and consultancy - Balance AotearoaView full profile
Business Information Manager - Ember Korowai TakitiniView full profile
Service Clinical Director, Adult Community Mental Health Services - Auckland DHBView full profile
Chief of Psychiatry and Director of Area Mental Health Services - Canterbury DHBView full profile
Adult Operations Manager, Specialist Mental Health and Addiction Service - Waitematā DHBView full profile