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The positive impact of Knowing the People Planning

What:A practical approach to service evaluation.

Why:To improve service delivery and health outcomes for long-term service users.

How:Using the Knowing the People Planning evaluation system to inform service delivery by assessing real outcomes for service users.

Target:Long-term service users.

Where:Community Mental Health Services, Hawkes Bay District Health Board.

The profile

Community Mental Health Services in the Hawkes Bay region are provided by four community mental health teams and an after hours Crisis Assessment and Treatment Team, with a total of around 30 full-time equivalent (FTE) staff including nursing, medical, and allied health practitioners. The teams are based in the two main centres of Napier and Hastings and in two small rural communities of Waipukururu and Wairoa.

Knowing the People Planning (KPP) is a service evaluation system that was developed in the late 1990s. Based on ten key features identified by service users, their families and clinicians as constituting a good mental health service, KPP offers a simple, flexible system that can be used locally to evaluate real outcomes for service users.

By using KPP, Hawkes Bay District Health Board (HBDHB) mental health services have been able to measure outcomes related to real people, the impact of services on recovery and how well their services are delivering the 10 key features of good service provision. KPP has also enabled HBDHB to capture the impact of changes in service delivery and resources on service users. This information has been used to influence planning and funding and to evaluate service response to individual service user needs such as GP support, housing or employment. Data collection is ongoing and routinely adapted to local priorities.

The beginnings

In the early 2000s, feedback from mental health clinicians and service users in the Hawkes Bay suggested there was a lack of integration between services. Major gaps were identified in the range and level of support offered to service users. In response, HBDHB established the Pathway Forward team to facilitate and initiate change.

In 2003 two of the clinical leaders, John Conneely and Kim Henneker, were invited to work with the Ministry of Health KPP pilot project. The exercise they participated in demonstrated KPP could be a useful tool for measuring service delivery and health outcome changes. The evaluation system could also indicate whether service investments were making any real difference to service users. After the pilot proved successful KPP was implemented with long-term service users at the two main centre community mental health teams.

In the beginning of 2004, 29 practitioners from the four community health centres were asked to complete the simple 10 question KPP survey every six months. Results of the survey are regularly fed back to the practitioners. As a result, clinicians were able to understand how KPP findings were used and how this information could have a positive impact on service development. KPP has now become part of day-to-day practice and the information has been used to inform service develop and resources.

The process

KPP system was used as an assessment tool for service delivery and its effect on service users' lives. It can be used alongside the clinical work. The KPP survey consists of demographic information and 10 key questions.

The data collection process involves the following.

  • Team leaders and clinicians work together to identify long-term service users.
  • Clinicians then go through the data collection process with the service users.
  • Team leaders ensure that data is entered by the required deadline.
  • An analysis of the data is done every six months and presented back to clinicians, this process provides information about service successes and gaps.

The community mental health teams meet regularly to review the trends and themes identified by the collected data. The teams also identify what steps need to be taken to address the gaps in the service. These could include increased support for stable housing, improved access to primary health care, support for paid employment or having less people on antipsychotic depot medication.

Information from KPP is shared with funders and planners and presented to external agencies such as non-governmental organisations (NGOs) and primary health organisations (PHOs). The Mental Heath and Addiction Advisory (MHAC) group, which includes the consumer advisors, families, community groups, NGOs, and service user support groups also regularly reviews KPP data. This group then works together to address the trends and gaps identified by the data and create solutions using a combination of resources.

The unique approach

  • Using KPP has enabled HBDHB's community mental health services to address specific outcomes for service users with experience of enduring mental illness.
  • KPP promotes a service delivery model including guaranteed access to relevant services, continuity of care, social inclusion, service accountability and service coordination.
  • KPP assists HBDHB in addressing identified gaps in service provision.
  • KPP uses data collection to identify the actual number of people with specific needs and aids the development of flexible individualised supports for service users.
  • KPP data collection has now been integrated into the computerised patient management system. This makes the information visible to all staff and it is also quicker and easier to collect and report on.

The results

The introduction of KPP resulted in a number of positive changes at an individual and service level. There have been positive results in improved ease of entry or recognition of individuals without the need for them to re-tell their story to access services, access to effective primary health services including healthy lifestyle support and management of chronic illness and access to suitable housing or employment. In particular improved outcomes have included the following.

  • Planning for recovery and relapse prevention has improved and the percentage of service users with completed recovery and relapse prevention plans has increased from 45 per cent in 2004 to 91 per cent in December 2007. The average length of stay in hospital has decreased by 25 per cent for long-term service users since 2004.
  • At HBDHB all data (including recovery and relapse plans) is now stored electronically and is accessible to staff to ensure easy access to services.
  • After the first data collection revealed 6 per cent of service users had no GP a ‘hassle free' GP service was created at a local service user drop in centre. By 2006 the number of service users with no GP had decreased to 2 per cent.
  • Since data collection was begun at HBDHB service users with access to support services increased from 25 per cent to 78 per cent in 2006. Service users with some form of paid employment also increased from 7 per cent (early 2005) to 25 per cent in December 2006.

The lessons learnt

  • Leadership has been a key factor in the implementation and sustainability of KPP at Hawkes Bay. Finding champions who can lead the implementation and a focus on staff training and education is important.
  • Having a consistent, integrated system will ensure that the use of KPP continues when staff and service users move on.

More information

Contact

Website

Hawkes Bay District Health Board

Hawkes Bay DHB

Documents/links

Download this story in PDF format

The information on this page is also available for download in PDF format.

The positive impact of Knowing the People Planning: making a real difference at Hawkes Bay District Health Board (PDF, 107KB)

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Page last updated: 7 November 2008