These are our current Child and Youth stream Key Performance Indicators. Click on any indicator to read more about the technical definitions.
You can also read more about the definitions in this document.
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
a. Exclude all activities where either of these criteria are met:
b. Rank all remaining in scope activities by Activity Start Datetime, Referral ID, Activity ID
c. Calculate the Ranked Order for each in-scope activity (sorting by Activity Start Datetime, and then Referral ID and Activity ID to tiebreak)
d. Where Ranked Order = 1, this is the first in scope activity on the service episode
e. First In Scope Activity Start Datetime = Activity Start Datetime of this first in scope activity
f. Where Ranked Order = 3, this is the third in scope activity on the service episode
g. Third In Scope Activity Start Datetime = Activity Start Datetime of this first in scope activity
4. Calculate the wait time for each service episode:
a. Wait time to first in scope activity = difference in days between Service Episode Start Date and First In Scope Activity Start Datetime
b. Wait time to third in scope activity = difference in days between Service Episode Start Date and Third In Scope Activity Start Datetime
5. Calculate additional service episode metadata for use in analysis:
a. Service Episode End Date = maximum Referral End Date of all referrals within the service episode
b. Service Episode End Code = Referral End Code associated with the referral that has the maximum Referral End Date of all referrals within the service episode
i. Where multiple referrals share the maximum Referral End Date, if a DR exist then this is chosen. Otherwise the first alphabetical Referral End Code is chosen
c. Count Referrals = count referrals included in this service episode
d. Count Team Types = count of team types included in this service episode
e. Initial Team Type = Team Type of the index referral
f. Age at Service Episode Start = age in years on the Service Episode Start Date
g. In Scope Activity 365 Days Prior – Same Org? = if there exists an in-scope activity for this tangata whai ora at this organisation in the 365 days before Service Episode Start Date, them 1 else 0
h. In Scope Activity 365 Day Prior – Any Org? = if there exist an in-scope activity for this tangata wha ora at any organisation in the 365 days before Service Episode Start Date, then 1 else 0
i. Client Type =
i. If In Scope Activity 365 Days Prior – Same org? = then “Recurring – same organisation” else
ii. If In Scope Activity 365 Days Prior – Any org? = 1 then “Recurring – another organisation” else
6. Calculate additional activity flags for analysis:
a. Details of the first in scope activity based on its ActivityType
i. FirstInScopeAcitivityIsInpatient? = 1 if ActivityType in (T02, T03, T04)
ii. FirstInScopeActivityIsCommunityCrisis? = 1 if ActivityType in (T01, To5)
iii. FirstInScopeActivityIsCommunityNonCrisis? = 1 if ActivityType not in (T01, T02, T03, To4, T05)
iv. FirstInScopeActivityIsCommunityResidentail? = 1 if ActivityType in (T25, T26, T27, T28, T29, T30, T48)
v. FirstInScopeActivityIsCrisisorInpatient? = 1 if ActivityType in (T01, T02, T03, T04, T05)
b. Count out of scope activities before first in scope activity = count of all activities on a service episode where Activity Start Datetime < First In-Scope Activity Start Datetime and where the activity is not in scope (per the standard ActivityType definition)
An overlap is established by comparing referral start and end dates, not datetimes. For example, if Referral A ends at 09:30 on 01/01/2020 and Referral B begins at 23:30 on 01/01/2020, this is an overlap and these referrals will be combined. On the other hand, if Referral A ends at 23:30 on 01/01/2020 and Referral B begins at 00:30 on 02/01/2020, this is not an overlap and these referrals will be in separate service episodes (assuming there are no other referrals for this tangata whai ora).
When combining referrals, be careful not to simply sort referrals by start date and check for an overlap with the previous referral; tangata whai ora may have a single ongoing referral that overlaps multiple other brief referrals and forms a single service episode even though none of the brief referrals overlap one another.
Open referrals (Referral End Date = null) are included at step (1) regardless of whether an in-scope activity exists on that referral. This is to ensure that we reconstruct accurate service episodes, rather than discard pieces of a service journey.
The wait time is calculated using calendar days, not 24-hour periods. For example, a service episode starting at 09:00 on 01/01/2020 with the first in-scope activity at 23:30 on 01/01/2020 would have a wait-time of 0 days. A service episode starting at 23:30 on 01/01/2020 with first in-scope activity at 00:30 on 02/01/2020 would have a wait-time of 1 day.
There is no mechanism to categorise a service episode as urgent.
When identifying the Third in-scope activity, there is no correction for duplicate activities, and activities that occur on the same day are all considered individually. This is how a single service episode can have 0 days to both first and third in-scope activity, when three separate activities occur on the day of service episode start.
When allocating a service episode to a reporting period, we use the Service Episode Start Date.
The total number of community treatment days on which one or more activities are recorded for a service user by an in scope community team. The activity may involve the service user directly or indirectly, for example it may be in relation to the service user’s care but the service user may not necessarily be present. Activities coded as T35 (DNA) are excluded.
Treatment days with family whanau involvement: Total number of community treatment days provided by the mental health and addiction service organisation’s community mental health and addiction services within a three month reference period that include:
a. In scope activity types:
i. T32 contact with family whānau, consumer not present
ii. T36 contact with family whānau, consumer present
iii. T47 support for family whānau
b. Out of scope activity settings:
i. WR written correspondence
ii. SM SMS text messaging
iii. OM other social media, e-therapy
7. Inclusion of open referrals, i.e. where referral end date = NULL
8. Exclusion of Alcohol & Drug Teams (AOD) and Forensic Services
9. Exclusion of NGOs
10. Results reported for the most recent one to two quarters are highly likely to be preliminary when first eligible face to face activity or first whānau contact are retrospectively submitted to PRIMHD.
Process of identifying and collapsing overlapping eligible episode from PRIMHD:
Total number of DNA contacts for in scope community services in the reporting period.
DNA – T35 Did not attend
Total number of contacts, including DNAs, for in scope community services in the reporting period.
In May 2020, the KPI Programme received an 18-month contract variation from the Ministry of Health to explore the development of a youth forensic KPI stream. As part of this variation, the KPI Programme is undertaking research to provide an evidence base for potential indicators that relate to the national youth forensic model of care. Development of potential indicators is done through a collaborative process with the sector and the Ministry of Health.
If you are interested in finding out more about the work we are doing in youth forensic mental health services, or would like to contribute to the scoping of this potential new stream, please contact us.
Our Child and Youth 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.
Consultant, Adolescent Forensic Psychiatry, Nga Taiohi (3 DHB) - Capital and Coast DHBView full profile
Youth Consumer Advisor - Werry Workforce WhāraurauView full profile
Clinical Manager iCAMHS - Lakes DHBView full profile
Clinical Coordinator - iCAMHS - Nelson Marborough DHBView full profile
Psychiatrist - Hawkes Bay DHB and Psychiatrist Regional Forensic Services - Capital and Coast DHB
Child and Youth Director - Pathways and RealView full profile