We have been using ReQoL in our inpatient and community psychiatric rehabilitation services from the initial pilot. The team value ReQoL as a tool which is simple to use and understand, and relevant to the wellbeing of individuals. 

It’s fair to say there have been a fair few challenges in implementation which the team continue to work hard to overcome. 

Clear leadership from the trust outcomes lead, clinical leaders and positive feedback from service users have been key factors in nurturing and embedding a new culture. I am delighted to be able to share some of our learning in the R and R service with you, and hope it will inspire people to keep going on their journey.

Key learning

The process of completing a ReQoL and talking about it with staff is reported to be useful by service users and they don’t mind filling the forms in. Staff opinion, organisational culture and systems are much harder to change.

Value and support your clinical leaders, invest in them. Allocate time for training and have conversations about ReQoL as a clinical tool, how it aids conversations. Make sure the focus is clinical usefulness, not service targets. Model this.

Plan and test out how the data will be inputted into your EPR. Ensure there is a way to get reports back to staff and more importantly service users before you start handing out the measures. I am sure others have witnessed how demoralising it is for people to fill these in and get nothing back, and this doesn’t serve any purpose for them to sit in either a box or an electronic data warehouse.

The system to retrieve reports needs to be simple, and ideally automatic. Our journey with this has taken time and hard work and close liaison between leads and IT colleagues.

Initially staff had to go through a data warehouse to get reports. Most clinical staff were not familiar with this. This was so complex that even I gave up! The reports were not very clinically useful, but showed managers how many had been completed.

Reports were then built into PARIS our EPR. The process of requesting a report in PARIS was hard to recall, easy to make mistakes with and took time. With persistence and leadership one of our teams embedded this into their care pathway. Every three weeks staff complete a ReQoL with a service user, input the data and then get the report printed for the service users team review meeting. This wasn’t possible in other settings though and I am super proud of this team in making this happen.

We have worked closely with information colleagues with a goal of generating automatic reports to go to the care coordinator and other key staff by email the next day, every time a ReQoL is completed. We are about to launch this, so I will have to tell you more about how it goes then. 

A mock example of a graph of scores over time is shown below. This is accompanied by the breakdown of scores over time for each individual question – thus enabling rich discussions.