MEASURING QUALITY IN MENTAL HEALTH SERVICES ACROSS Nova Scotia evaluation of a demonstration site

Policy makers need the routine measurement of outcomes to monitor and evaluate progress towards more effective health care and better health, as well as monitor the quality of services. Clinicians also need routinely measured outcomes if they plan to evaluate the effectiveness of their clinical work and identify areas for improvement. However, mental health outcomes are complex and difficult to operationalise. As such, it is difficult to develop precise yet meaningful outcome measures. This study seeks to evaluate the Health of the Nation Outcomes Scale (HoNOS) as a performance indicator and tool to improve the quality of care. The HoNOS will be introduced into routine clinical care across one health district in Nova Scotia. The HoNOS scores will be recorded in the mental health administrative database and fed back to clinicians on individual patients, and to managers in aggregate form, as tools to improve the quality of care at system-, institution-, provider-, and patient-levels. We will therefore directly address current Federal and Provincial priorities for mental health services by ensuring that health outcomes assessment across Nova Scotia is informed by the scientific literature and fully evaluated. Through use of an internationally accepted instrument (HoNOS), we will also be able to make national and international comparisons of outcome.