From not knowing to doing: An interprofessional approach to clinician training in use of Goal Attainment Scaling (GAS) as a recovery-oriented outcome measure in a rural mental health service.

Outcome measurement and feedback are key to quality improvement in healthcare. Goal attainment scaling (GAS) is a tool that could be used to measure outcomes of mental health services delivering recovery-oriented care. The objective of this prospective study was to evaluate the effectiveness of tailored, interprofessional, multilevel and adaptable GAS training on clinician views, learning, competence, performance and confidence in the use of GAS. Thematic analysis of eight clinician participant views was done using the method proposed by Braun and Clarke (Thematic analysis: a practical guide to understanding and doing, 2022). Four main themes were generated: clinicians found that this type of training is useful, GAS influenced the way they thought about their roles in goal setting and recovery-oriented care and COVID-19 pandemic impacts. Furthermore, clinicians' skills to set scalable GAS goals with consumers and clinician confidence in using GAS improved. The results of this study show a positive impact of tailored, interprofessional, multilevel and adaptable training supporting development of clinician skills in the GAS process. The training design had a favourable effect on clinician views, learning, competence, performance and confidence of GAS as a recovery-oriented outcome measure. The approach to GAS training and use of GAS as a recovery-oriented outcome measure should be considered in response to mental health service reform.

"Will I come home incontinent?" A retrospective file review: Incidence of development of incontinence and correlation with length of stay in acute settings for people with dementia or cognitive impairment aged 65 years and over.

AIM: The aim of the retrospective file review is to obtain incidence of the development of incontinence at time of discharge from an acute/sub-acute care setting for patients who were aged 65 years and over, diagnosed with dementia or cognitive impairment, ambulant and continent pre-admission. Along with, identifying correlation between length of stay and development of incontinence. The data were obtained to measure a need for recommendations related to continence promotion in hospitals. It is hypothesised that the sample group are at risk of developing incontinence throughout their stay. METHOD: Files for the sample group who were admitted to a regional Victorian hospital acute/sub-acute care over a two-year period were reviewed. A total of 182 files were reviewed, of which 100 files met the inclusion criteria. RESULTS: The study revealed a significant relationship between admission and the development of incontinence for the sample group (p = .007). At time of discharge from the hospital, 36% suffered urinary incontinence. Of the 36%, 2% also developed new faecal incontinence at time of discharge. A further 21% of patients also experienced an episode of urinary incontinence throughout their stay, but were continent at discharge. An independent-sample t-test was conducted to compare mean length of stay between the group that remained continent (M = 15.88, SD = 13.028) and the group that developed incontinence (M = 24.33, SD = 19.497); t(98) = 2.586, p = .011 (two-tailed). CONCLUSION: Statistically significant results confirm the hypothesis' that the; sample group are at significant risk of developing incontinence throughout a hospital admission, and increased length of stay increases the likelihood of developing a form of incontinence.