Implementing routine outcome measurement in psychosocial interventions – a systematic review

ABSTRACT

While routine outcome monitoring (ROM) has been found significant for psychosocial outcomes, the issue of how to implement ROM remains under researched. This review explores the ROM implementation literature via searches through PsychInfo, SocIndex, Academic Search Elite and Social Sciences Citation Index following PRISMA guidelines to generate a comprehensive view of implementation. 2958 articles were identified of which 48 were included. The literature on ROM implementation refers to a wide variety of systems, at various stages of development, in use in a wide variety of psychosocial contexts. Much of the literature is methodologically weak and written by consultants, managers and researchers about their experiences. The literature shows a field characterised by a high degree of experimentation. Findings were identified concerning management/leadership, inter organisational factors, a top down and bottom up process, ROM feedback culture, the implementation team, coordinators/champions, staff factors, supervision/consultation, training, measures, reports, generating a language for ROM use in clinical practice and client factors. More research is required with regard to making routine measurement not merely relevant to, but an integral and explicit part of, everyday clinical practice. Furthermore, the impact of ROM implementation for the organisational structures and development needs to receive more attention.

RESUMÉ

Mens rutinemæssig effektmåling (ROM) har vist sig signifikant i forhold til at forbedre effekter af psykosociale interventioner, er selve implementeringen af ROM relativt uudforsket. Med udgangspunkt i PRISMAs retningslinjer afsøger dette review litteraturen om implementering af ROM ud fra databaserne PsychInfo, SocIndex, Academic Search Elite og Social Sciences Citation Index. Ud af de 2958 identificerede artikler, blev 48 artikler inkluderet. Litteraturen om implementering af ROM tydeliggør en stor variation af redskaber, som er på forskellige udviklingsstadier, og som bliver brugt i meget forskellige psykosociale kontekster. Meget af litteraturen er metodisk svag. Det er udarbejdet af konsulenter, ledere eller forskere og vedrører deres erfaringer med ROM. Litteraturen viser endvidere, at området i høj grad er karakteriseret af eksperimenter. Resultaterne fra dette review peger på, at fokus i litteraturen er på følgende faktorer: ledelse, interne organisatoriske faktorer, top-down og bottom-up processer, feedback kulturen i ROM, implementeringsteamet, koordinatorer/superbrugere, personale faktorer, supervision/konsultation, træning, målinger, rapporter, udvikling af sprog for brugen af ROM i praksis, samt faktorer vedrørende klienterne. Der er brug for mere forskning for at gøre ROM til en integreret og eksplicit del af praksis, og mere opmærksomhed bør rettes på betydningen af implementering af ROM for en organisations struktur og udvikling.

KEYWORDS:

• Routine outcome monitoring
• psychotherapy
• mental health
• outcomes
• implementation

EMNEORD:

• Rutinemæssig effektmonitorering
• psykoterapi
• mental helbred
• effekter
• implementering

Acknowledgements

The first author designed the study and wrote the protocol. Both authors conducted literature searches and reviewed the articles. The first author wrote the first draft of the manuscript. The second author wrote the methodology section. Both authors have approved the final manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes on contributors

Thomas Mackrill is a reader in social work at University College Copenhagen. Thomas is a clinical, social and research psychologist, and has worked with a wide range of client groups in the public and private sector. Thomas’ research presently focuses on the interfaces between statutory social work and psychosocial interventions in child, family and youth social work.

Kresta M. Sørensen is a lecture at the Institute for Social Work at University College Copenhagen. She is trained as a social worker in 2004 and has worked for e few years in practice. In 2007 she started working with research, which concerns vulnerable children and families, children in out of home placements as well as interventions in social work.

Additional information

Funding

Funding for this study was provided by the A. P. Møllerske Støttefond. They had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication.