The *National Mental Health Plan 2003 -2008 * identified priorities that would guide the next phase of information development that aims to focus on fostering a service delivery culture in which information is used to support decisions at all levels and encourage quality improvement initiatives. It is envisaged that:
- data is used routinely to contribute both to improved clinical practice and service management; and
- benchmarking is established as the norm, and is used in a quality improvement cycle, with all services having access to regular reports on their performance relative to similar services.
Although the National Mental Health Plan 2009 – 2014 is curently being developed, the National Mental Health Policy 2008, released in 2009, notes that “….Continued efforts to improve the monitoring of service quality must be encouraged. The importance of listening and responding to the consumer and carer experience to inform service development should be recognised. Quality assurance programs, benchmarking activities and independent accreditation initiatives should be fostered, both locally and nationally to improve accountability….”
The seminal document that underpins benchmarking within the mental heath sector is Key Performance Indicators for Australian Public Mental Health Services. This report proposed a set of thirteen key performance indicators (KPIs) that could be constructed based on available data collected by all Australian States and territories. These KPIs were used in the National Mental Health Benchmarking Project and in the Forensic Mental Health Services Benchmarking, both facilitated by AMHOCN.
National Mental Health Benchmarking Project
In 2006, the National Mental Health Benchmarking Project, a collaborative initiative between States, Territories and the Australian Government, established demonstration benchmarking forums within the four main program areas of public sector mental health services (adult, child and adolescent, older persons and forensic).
There were four core objectives in undertaking the national project:
- To promote the sharing of information between organisations to increase understanding and acceptance of benchmarking as a key process to improve service quality.
- To identify of the benefits, barriers and issues arising for organisations in the mental health field engaging in benchmarking activities.
- To understand what is required to promote such practices on a wider scale.
- To evaluate the suitability of the national mental health performance framework (domains, sub domains and key performance indicators) as a basis for benchmarking and identifying areas for future improvement of the framework and its implementation.
National Mental Health Benchmarking Project Forums
Each forum consisted of between four and eight mental health service organisations from across six jurisdictions. The forums were aligned with the main program streams within the mental health sector:
National Mental Health Benchmarking Project Resources
The follow two documents describe the nationally agreed key performance indicators for use in mental health services across Australia.
The first edition, Key Performance Indicators for Australian Public Mental Health Services released in 2004, defined a mental health specific performance framework (the Framework) and a set of ‘phase one’ indicators. This represented the mental health sectors’ first attempt to articulate a common framework and standardised set of indicators to support benchmarking and guide quality improvement at the level of the mental health service organisation.
The second edition, Key Performance Indicators for Australian Public Mental Health Services 2011, is based primarily on learnings and advice from states and territories and the output of the National Benchmarking Project, and represents the culmination of work to date to refine and enhance the original set of indicators published in 2005.
The third edition Key Performance Indicators for Australian Public Mental Health Services 2013 brings together the most current statement of the national mental health performance framework and draws on advances made by states and territories as the framework has been progressively implemented and refined.
To facilitate the dissemination of information about the benchmarking project and to assist in the development of benchmarking activities in Australia’s mental health services, services participating in the four Benchmarking Project streams agreed that the following information would be made available.
Project Manuals Part 1 – 3
Benchmarking Project Manual Part 1: General information for participating organisations aims to assist services participating in the forums by providing basic information about: the background to, and objectives of, the national benchmarking project; the current status of benchmarking in Australian mental health services; the expected benefits for participating organisations; how the forums will be coordinated; the plannned timetable of activities; how the forums will be run; what information will be benchmarked; and how the project will be evaluated.
Benchmarking Project Manual Part 2: Basic concepts to guide indicator development and desirable attributes of performance measurement systems provides useful background to key concepts in key performance indicators. The first section describes six key issues upon which a shared understanding is needed and which are central to the design of any performance measurement framework within the health care industry. The second section summarises the attributes of performance measurement systems described in the literature as important to success. They emphasise that an effective performance measurement approach does not come easily and requires careful planning.
Benchmarking Project Manual Part 3 V1.1: Technical specifications for the national KPIs has been prepared to guide organisations on how to prepare the national key performance indicators (KPIs) from their locally available data. The focus is on the 13 national KPIs described in the document ‘Key Performance Indicators for Australian Public Mental Health Services’ as these are the main indicators used in the benchmarking forums.
The National Mental Health Benchmarking Project Evaluation Report July 2009 outlines the results of the evaluation of the National Project and the extent to which the project met its core objectives. The information is primarily sourced from participants’ experience of two years of benchmarking activity. The evaluation shows that benchmarking is a useful tool to enhance understanding of initiatives to improve service delivery and support quality. It also highlights that sustainable benchmarking activity is a complex and evolutionary process, influenced by a range of factors, especially organisational capacity and commitment.
Forensic Mental Health Services Benchmarking
AMHOCN Training and Service Development is supporting and facilitating ongoing benchmarking in forensic mental health services. The participating services have met in May and November 2009 and July 2010. Discussions have focussed on comparisons of data collected for Key Performance Indicators and the reasons for variation across services. Participants have discussed service profiles and are undertaking special projects in areas of interest.
One key activity has been an annual snapshot census of the participating forensic mental health services. This census provides additional information that assists in understanding the forensic mental health population, the services provides and the differences between organisations. The data dictionary developed for the 2010 snapshot census can be downloaded.
The Calendar will provide information on forthcoming meetings of the Forensic Mental Health Benchmarking participants.