The national continuous quality improvement tool for mental health education: Results of targeted and supported implementation in England

Evaluating the feasibility of complex interventions in mental health services: standardised measure and reporting guidelines

BACKGROUND

The feasibility of implementation is insufficiently considered in clinical guideline development, leading to human and financial resource wastage.

AIMS

To develop (a) an empirically based standardised measure of the feasibility of complex interventions for use within mental health services and (b) reporting guidelines to facilitate feasibility assessment.

METHOD

A focused narrative review of studies assessing implementation blocks and enablers was conducted with thematic analysis and vote counting used to determine candidate items for the measure. Twenty purposively sampled studies (15 trial reports, 5 protocols) were included in the psychometric evaluation, spanning different interventions types. Cohen's kappa (κ) was calculated for interrater reliability and test-retest reliability.

RESULTS

In total, 95 influences on implementation were identified from 299 references. The final measure - Structured Assessment of FEasibility (SAFE) - comprises 16 items rated on a Likert scale. There was excellent interrater (κ = 0.84, 95% CI 0.79-0.89) and test-retest reliability (κ = 0.89, 95% CI 0.85-0.93). Cost information and training time were the two influences least likely to be reported in intervention papers. The SAFE reporting guidelines include 16 items organised into three categories (intervention, resource consequences, evaluation).

CONCLUSIONS

A novel approach to evaluating interventions, SAFE, supplements efficacy and health economic evidence. The SAFE reporting guidelines will allow feasibility of an intervention to be systematically assessed.

Perceptions of service user and carer involvement in healthcare education and impact on students' knowledge and practice: a literature review

BACKGROUND

The involvement of service users in healthcare education has followed an increasing focus on patient-centred services. CETL4HealthNE, regional healthcare education collaboration, undertook a literature review to inform involvement strategies.

OBJECTIVES

To identify--approaches used to involve service users in healthcare education curricula; perceptions of key stakeholders; impact of involvement on students' knowledge and skills, and the quality of care delivered.

METHOD

A structured search of the literature on service user involvement in Higher Education healthcare curricular activity was undertaken (July 2006-February 2007). Papers were screened and data extracted and synthesized according to the aspect of the curriculum enhanced by involvement and level of impact evaluation.

RESULTS

Thirty papers addressed interventions in pre- and 11 in post-registration education. Thirty studies reported on evaluation. Students and service users both benefited from service user involvement in health care programmes. There was limited evidence that involvement changed behaviour in practice or significantly benefited the recipient of care.

CONCLUSIONS

Service user involvement in curricular developments for healthcare professionals is a policy imperative aimed at improving their experience of services. Despite a limited and weak traditional evidence base for impact on students' knowledge and practice, both students and service users identify benefits from engagement. Further development of evaluation methodologies is required.