| Diagnosis and Assessment Only [message #248] |
Fri, 29 April 2005 01:03  |
 Dean Lewin
Messages: 18
Registered: April 2003 |
Junior Member |
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Hi,
QLD is in the process of finalising modifications to the collection protocol, so that we can clearly identify at what point an episode of mental health care commences when a person first presents to the mental health service.
In essence ..
A new service episode would commence and an admission NOCC collection occasion would be required at the conclusion of the consumers first in-person assessment only if any further services for the consumer is planned by the mental health service (within the next 90 days).
However, if at the end of the first in-person assessment the treating team decides that there are no plans for any further services with the consumer (within the next 90 days), or if an in-person assessment has not occurred, a Service Episode would not commence (but that an "assessment only" collection occasion MAY be recorded, but not submitted as part of the NOCC collection).
We are in the process of finalizing the measures that would be included in an "assessment only" collection occasion. Clearly HoNOS (and it's variations) would make the cut, but the question has arisen whether diagnosis should be included as well. Particularly given that this would provide valuable case complexity information for these "assessment only" presentations.
My question is, are any other jurisdictions collecting diagnosis at this point as part of their outcomes collection protocols and/or what issues are relevant when considering the inclusion of diagnosis for this type of collection occasion?
Any comments would be greatly received.
Thanks
Dean Lewin
Mental Health Unit
Queensland Health
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| Re: Diagnosis and Assessment Only [message #249] |
Tue, 03 May 2005 17:41  |
Tim Coombs
Messages: 104
Registered: December 2002 |
Senior Member |
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Hi Dean,
Diagnosis is another of those tricky issues. For NOCC the diagnosis being collected is the Principal Diagnosis which is “the diagnosis established after study to be chiefly responsible for occasioning the patient or client’s care in the period of care preceding the Collection Occasion” So by NOCC definition it can’t be collected on admission. However, diagnosis is a contentious issue and in training there is often heated discussion about who can or can not make a diagnosis, what are the medicolegal implications of attaching that diagnostic label to the consumer etc. There is a useful discussion regarding reporting diagnosis in Community mental health care 2000–01 : Review of data collected under the National Minimum Data Set for Community Mental Health Care available from the AIHW website http://www.aihw.gov.au/index.cfm This highlights the variation across jurisdictions in their approach to this issue (see chapter 6).
Cheers
Tim
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