Client Outcomes Management System (COMS)

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Project Overview

In 2008, as part of the then NSW Health (now Ministry of Health) strategy, A New Direction in Mental Health, NADA was funded to undertake an information management project. The goal of this project was to improve the way outcomes of care are measured in non government drug and alcohol organisations in NSW, with a particular focus on co-occurring disorders and mental health outcomes in drug and alcohol services. 

In January 2009 NADA released the Drug and Alcohol and Mental Health Information Management Project Background Paper  (2009). This paper outlines the scoping for the project undertaken by NADA, background on data collection, the use of data for screening, assessment and treatment planning, some information on the use of these tools in the NGO drug and alcohol sector in NSW. This background paper also outlined the objectives of this project. The main outcome for the project is the development and implementation of a system for the routine measurement of client outcomes. The broad objective of the project is to improve treatment outcome measuring for clients presenting to non government drug and alcohol treatment agencies.

In 2009 NADA also convened a project advisory group comprising a wide range of highly skilled and experienced representatives of a variety of stakeholders, including senior researchers in the drug and alcohol and mental health field, staff from the Ministry, experts in data collection and use, NADA members, and other stakeholders.

In 2009 also, NADA commissioned two consultants. One of these was a researcher from the National Drug and Alcohol Research Centre who over the course of 2009 produced for NADA and the NADA membership an excellent overview of screening, assessment and outcome measurement tools used in the drug and alcohol and mental health sectors. This document was entitled A Review of Screening, Assessment and Outcome Measures for Drug and Alcohol Settings  (2009), and has proven itself to be a very useful summary of 56 different measures available in areas such as Global Instruments, General Health and Functioning Instruments, General Mental Health Instruments, Specific Mental Health Instruments, Positive Mental Health Instruments, General Drug and Alcohol Instruments, Drug and Alcohol Severity Instruments and Craving Measures. This document was made publically available and has been used by services and organisations outside the NADA membership for example corrective services in NSW and drug and alcohol and mental health agencies in other states.

As part of the Improved Services Initiative, NADA also produced a shortened summary version of this document with links to the measures described, entitled Summary Table of Assessment and Outcomes Measure Tools (2011).

The second consultant was commissioned to evaluate the project at a number of defined periods, seeking feedback from NADA members and evaluating against project objectives using a Results Based Accountability approach. In May 2009 the independent evaluator released the   NGO Drug and Alcohol and Mental Health Information Management Project Evaluation Framework (2009). This framework outlined the three areas that would be evaluated, increase in member's collection and use of data, increase in staff's skills and understanding around gathering and use of data and recognition of the database created by ANDA as being useful. The framework also outlined an evaluation timeline. 

 In September 2009, the evaluator released the NGO Drug and Alcohol and Mental Health Information Management Project Baseline Evaluation (2009). This evaluation was comprehensive; outlining the background to the project and data collection and information management in the NGO drug and alcohol sector, and also undertaking a comprehensive survey of NADA's members, how they use data and what they would want from the project. Some of the findings that informed the next stage of the project were that our members were interested in

  • - NADA introducing a standard data collection tool.
  • - NADA modifying its own database.
  • - NADA host sector workshops and information session.
  • - Client profile and outcome data across the sector to be distributed periodically.

 

In December 2009, after extensive consultation with its advisory committee and after seeking other expert advice, after thorough consideration of the Review of Measures  report and other published reports  and in light of the findings from the Baseline Evaluation  (2009), NADA released its Outcomes data set and the document Determining the Treatment Outcomes Dataset (2009).

For a number of reasons outlined in this paper, including ease of use/client self report, high validity/reliability, common usage including use by GPs and state mental health services (e.g. the K10+), and freedom from registration costs the project decided on the following measures, with questions falling into four domains:

coms_tabledomains

A software developer was engaged to create an addition to the NADA online database to enable members to enter responses to these measures and to create reports on the data collected.

An expression of interest was put out the NADA membership for organisations who wished to undertake the pilot of the outcomes database. Of the expressions indicated, 8 NADA member agencies eventually came on board to be part of the pilot.

These were:

Karralika Programs Inc. (then known as Alcohol and Drug Foundation ACT)

Canberra
Calvary Riverina Alcohol and Drug Service Wagga Wagga
Freeman House (St Vincent de Paul Society) Armidale
GROW Rehabilitation Community West Hoxton
Kamira Wyong
Namatjira Haven Alstonville
Quamby House (St Vincent de Paul Society) Albury
WHOS (We Help Ourselves) Rozelle and Hunter Valley

 

Training in the use of the database was conducted at these services from April to December 2010.

In May 2011 the independent evaluator released the NGO Drug and Alcohol and Mental Health Information Management Project Pilot Evaluation  (2011).

The results of the Pilot Evaluation, including a great deal of constructive feedback from the pilot organisations and services, as well as visits to the pilot services by NADA staff led to a large overhaul of the data base to produce a second version of what was now called the COMS (Client Outcomes Management System). NADA worked on this with a new software developer throughout the rest of 2011, including a great deal of input from the pilot services.

Due to the lengthy period of development of the new version of the COMS, NADA commenced rollout of the database to NADA members in October 2011, and as at March 2012, a further 10 organisations, some with multiple services have begun using the database, with more due to commence.

The new version of the database, COMS v.2 is due to go live on the NADA website's online database in April 2012. Although the questions and the measures remain the same, COMS v.2 offers a much larger range of functionality (particularly reporting options) and a much better integration with the pre-existing MDS/NMDS section of the NADA online database. The COMS section of the online database will also be enhanced by scheduled improvements to both the NADA online database (of which it is a part) and the overall NADA website. For more information on the NADA online database generally please see the Information Technology page.

NADA has also entered into an arrangement with the Illawarra Institute of Mental Health at the University of Wollongong to produce a research report into the de-identified aggregate data of the sector. This report will enable the sector to look at the interactions between different outcomes (for example psychological distress and quality of life, drug use and severity of drug dependence, psychological distress and quantity of drugs used) as well as between demographic characteristics and treatment outcomes, length of stay and treatment outcomes, and many others.

For more information on COMS please contact: Suzie Hudson on Email: suzie@nada.org.au

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 "Easy acess of client information, fast and accurate".

 - Member user

 

 "Useful...Learning how to use the program in an easy protocal way and learning how to interpret the output graphs etc."

- Member user


coms feature


 Resource links

Drug and Alcohol and Mental Health Information Management Project Background Paper  (2009)

NGO Drug and Alcohol and Mental Health Information Management Project Evaluation Framework (2009)

NGO Drug and Alcohol and Mental Health Information Management Project Baseline Evaluation (2009)

Review of Screening, Assessment and Outcome Measures for Drug and Alcohol Settings  (2009).

Outcomes data set and the document Determining the Treatment Outcomes Dataset (2009).

NGO Drug and Alcohol and Mental Health Information Management Project Pilot Evaluation  (2011).

 COMS User Guide and Resources

COMS User Guide

COMS Questionnaire form

COMS Client Instructions

Standard drinks chart

Privacy and consent for clients

Followback- Client instructions

Followback- Staff instructions

Followback- Example calendar

Followback- MSWord template

Followback- PDF template