The first phase of the SILC pilot programme is currently underway and data collection will go live in May 2017. The project will run for the following 12-months concluding with a reflective residential meeting. In 2017.
The aim of the full programme is to guide a group of approximately ten services on the use of CORE Net for outcomes management and optimised service delivery. Using an ‘all teach, all learn’ approach, services will work with the SILC team and each other to develop their capability to rapidly test and implement sustainable and systematic improvements in the services they deliver. This will be achieved through the development and utilisation of data analysis and the effective application of service improvement methods and skills.
The SILC programme is based on the work of the Institute of Healthcare Improvement (IHI) in the USA and their model, ‘The Breakthrough Series’ – an improvement methodology developed to make breakthrough improvements in quality while reducing costs. The model focuses on spreading and adapting best practice across multiple settings and creating changes within organisations that promote the delivery of effective practices.
The underpinning conceptual framework is one in which services work together to share, learn and collaborate to apply best practice. Together, services will explore, plan and implement operational changes to delivery that will then be shared to enhance and benefit other Collaborating Member services. The project is split into 4 quarterly series focusing on:
- Data Quality
- DNAs (Did Not Attend)
- Unplanned Endings
- Improvement and Recovery
Each of these areas is crucial for improving service delivery and are increasingly being used by clients, practitioners, services, and commissioners so as to ensure the quality of provision and effectiveness of interventions.
In the absence of high-quality data, service quality development planning is severely compromised. This is due to the mostly unreliable reading about service delivery provided through poor data quality. The net result is that today’s commissioners and critical friends do not have confidence in the effectiveness of services due to the poor levels of transparency and accountability. Routinely collecting outcomes data will help overcome this.
Paying closer attention to reducing unattended appointments will lead to many potential benefits for the client, practitioners and overall service. Not only are there direct economic costs for missed appointments, but many other negative consequences, such as disrupting progress, discontinuing therapy, and demoralisation can be a likely outcome.
Early termination in psychotherapy and counselling services is a long-standing and widely recognised problem. Most dropout tends to occur early in therapy, far below the recommended treatment dose. Those who drop out prematurely have been shown to have higher outcome scores, attend fewer sessions overall (see figure above), and report being less satisfied with their treatment.
Improvement and Recovery are key outcomes in determining the effectiveness of service delivery. They represent a primary goal for any therapy service and are increasingly used as a measure of service quality and effectiveness. Understanding these can help services better understand the care they need to provide and the resources needed to deliver that care.
SILC Phase 1 Programme
The following table illustrates the plan for Phase 1 of the SILC programme. During this period, the SILC project will undertake a continuous process of action learning and collaborative evaluation activities culminating in retrospective focus and reflection over the course of this programme.