ADOM Training for Addiction Practitioners
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Poua ki runga
Poua ki raro
Poua ki tāmore nui
Nō Rangi, nō Papa
E Rongo! He āio!
Pai Mārire!
Establish above and below the connection with the sky and earth and a peaceful environment.
Let goodwill and harmony reign!
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For training addiction practitioners in the reporting and use of ADOM
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As an ADOM Trainer, you will be:
provided with information and resources to support
consistent collection and use
able to use the ADOM effectively and in accordance with
the ADOM Information Collection Protocol (ICP)
familiar with and use the
ADOM Guide for Addiction
practitioners
as a resource
able to impart this information back to your colleagues or
service.
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1
There are 2 modules to this training, Module one covers section 1 and 2:
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(
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Poll on confidence in training people with ADOM
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Background to health outcomes
Slides were sent to you prior to course, to be read before
training.
Any questions on these?
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Discussion: What are the differences between inputs, outputs and
outcomes
Take 10 mins. Very quickly introduce yourselves and then
discuss.
You will be automatically assigned a group and brought back to
the main group
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Outcome definition:
“
an outcome is a change in health, wellbeing and
circumstances over time.
”
(Te Pou 2012)
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:
•
standard set of statements or questions
•
defined points to measure
change
over a period of time
•
standardised rating system for each statement or question
The set of rules for rating the measure is called an Information Collection
Protocol (ICP).
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:
•
the same information is collected
•
in the same way
•
so information collected can compare change over time
(‘comparing apples with apples’).
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2
:
Implementing the ADOM
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Discussion: What does implementing ADOM mean to you?
5 mins to discuss. You won’t need to share or feedback to main
group
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’
Newest version is always on Te Pou website. Core document for national
implementation of ADOM.
includes:
•
information about ADOM
•
eligibility criteria
•
information collection protocol (ICP)
•
clinical pathways and collection occasions
•
facilitating ADOM collection
Referred to in the document as ‘the ADOM Guide’ or ‘the Guide’.
W
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s
A
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?
ADOM was developed in 2009 (current version 2013)
extensive consultation and validation process
high interest and demand for an outcomes measure for and from addiction
sector
ADOM implementation project
ADOM finalised and ADOM Feedback Wheel developed
Voluntary implementation 2014, mandatory rollout 2015.
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Refer to:
Section 1 -
About the ADOM in ‘ADOM Guide’
•
for use in adult community-based outpatient addiction services or
programmes
•
collaborative process – practitioner and tāngata whai ora
•
provides a summary of tāngata whai ora treatment journey
•
demonstrates change over time
•
NOT a clinical tool for screening, assessment or review.
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Discussion: What did you take from the video?
5 mins to discuss. You won’t need to share with main group
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Q
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Q10 – Q11 - injecting use and/or sharing needles
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Refer: Section 4.5 - Facilitating ADOM collection
in ‘ADOM Guide’
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Refer to Section 3 -
ADOM eligibility criteria in ‘ADOM Guide’
Which services are eligible to collect ADOM?
Which tāngata whai ora are eligible for ADOM collection?
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?
Refer to: Section - Essential training for ADOM clinicians
in ‘ADOM
Guide’
Information Collection Protocol (ICP)
clinical pathways and collection occasions
practitioner role
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(
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)
Refer: Section 4.1 Information Collection Protocol
in ‘ADOM Guide’
Following the ICP ensures we collect good quality data from tāngata
whai ora who have provided this information.
This means practitioners, teams, and services are all collecting the
‘same’ data and information - when it is used we know we are
comparing ‘apples with apples’.
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ADOM is collected during ‘an episode of care’ at the following treatment
stages:
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Your ADOM data collection and reporting system may provide a reminder
when due.
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Refer: Section 4.2
in the ADOM Guide for Addiction Clinicians on page 15
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4
.
3
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Discussion: What are the collection occasions for ADOM
10 mins to discuss. Choose someone in group who can
feedback your discussion to main group
Identifies the main focus of care provided over the period of care – ie 6 or
12 weeks:
engagement, screening and assessment
active treatment
continuing care.
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Refer to: Section 4.5 – The clinicians role
in ‘ADOM Guide’
collaborative – practitioner introduces and facilitates ADOM collection
process
motivational approach - positive engagement, listening and non-
judgmental feedback
ensure a safe confidential environment
integrate in to good clinical practice.
M
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Background to outcomes
Implementing ADOM
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:
How can outcomes information be useful?
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For data to be useful it needs to become part of every day practice – ‘what we do around
here’
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planning and phasing of implementation
user friendly IT structure and systems
training and education
quality improvement
outcomes coordination - local, regional, national.
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ā
ngata whai ora level
Service level
National utility
Informs and shape treatment.
“There is evidence that feedback improves recovery for clients” (Michael Lambert, USA)
Assist tāngata whai ora to view progress with their recovery
And
areas where progress has not occurred or intervention can be
offered
“Service users want to know how they are doing in a more systematic way” (AMHOCN)
Provides practitioners with a means for reviewing treatment planning and
goals with tāngata whai ora.
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provides a summary of change during treatment journey for tāngata
whai ora
covers many important aspects of the tāngata whai ora experience
and treatment eg ADOM – provide
information about:
•
alcohol and drug use
•
individual’s lifestyle and wellbeing
•
Individual view of progress and satisfaction.
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data collected must
•
be easy to use
•
easy to see what’s happening
•
offer benefit to all involved.
ADOM feedback wheel – provides a means of sharing a visual
representation of the service users progress with the tāngata
whai ora.
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Discussion: What did you take from the video?
5 mins discussion. No expectation on sharing with main group.
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.
National
Level
Service Level
Team Level
Interaction Level
tāngata whai ora and practitioner
Grouped information to understand
service users, understand outcomes,
and identify best practice
Promoting conversation about
individual’s goals and outcomes
Both of these
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From Report 11: Source: Ministry of Health, PRIMHD extract 1 November 2021, analysed and formatted by Te Pou.
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Discussion: the use of the feedback wheel
15 mins discussion. No expectation to share.
V
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New note added to item 7 in the ADOM form. If vaping is
involved record in Q7 and then specify amount of
nicotine in Q8
We will analyzing this vaping data once we have enough
in the system
Outcome measures are not decision making
tools…
B
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t
they can be useful tools for helping to make
good (informed) decisions
.
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f
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straightforward – easy to use measure
shared approach – practitioner facilitator – tāngata whai ora
responses
ADOM Information Collection Protocol (ICP) means we get consistent
data
provides a snapshot of change made for the tāngata whai ora and
practitioner
measures progress of treatment journey over time.
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4
:
Training trainers to train
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Because you are expected to train colleagues…
Yet may not have been provided the support,
opportunities, skills or developed the confidence to be
able to do that
and we don’t want to set you up to fail!
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‘I fully support the collection of Outcomes, for clients and national AOD
support in the future’
‘This enhances the proposed treatment plan, from a clients point of view’
‘Outcome measurements, if relevant, valid and appropriate ought to drive
practice’
‘Yes! Because we have already committed to it as a service’
‘I really like the feedback wheel, I will definitely use that
‘I can see the value of it’
‘It is required by our head office and I am nothing if not compliant with
their directives’.
O
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Need to:
repeatedly clarify the purpose of ADOM; and what it is not
reiterate in the training - what's in it for tāngata whai ora;
strengths focused
encourage integration in to ‘normal’ clinical processes
support data systems development
encourage buy in at ALL levels (tāngata whai ora, admin,
practitioners, team leaders, managers).
Preferred delivery styles
train the trainer or direct training delivery model
Variations in training delivered
content and competence
Variation in responsiveness
to training styles AND the ADOM use itself
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‘
The timeframes were a bit tight’
‘There needs to be ‘clear "learner" and "teacher“ hat times’
‘I need to trust the process and content-All the little ‘tweaks’ were
discussed as we went through the day’
‘I learned as much about how to introduce this to my staff by
watching the other attendees, as I did from the facilitators’
‘I appreciated the opportunity to get others perspectives. I agree that
the debate is valuable’
‘I Need to pitch this material at my colleagues level of understanding
– appealing to their existing strengths’.
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‘Ensure the teaching refers to client focus/centred practice’
‘More focus on a visual to help the client see recovery’
‘The training was helpful, but would need to repeat it prior to another assessment’
‘More structure, to the training’
‘Discussions were really helpful’
‘Not enough on what to do with the data’
Need practice with the ADOM document and asking the questions
‘I think that we needed to see the ADOM document briefly at the beginning, possibly start
with a scenario’
‘Good to have resources to take away’
W
h
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t
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l
s
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s
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d
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d
?
‘I would need to have it explained to me again prior to training others’
‘Practice and having another trainer to discuss things with (ADOM reflections)
‘Practical use of ADOM is very helpful. It is very different from knowing it on a
head level only’
‘What do we do with the data in terms of seeing the clients progress’
‘It is necessary to pull it together in my head’
‘More practice time – eek!’
‘Read over material again’
‘Contact with Project lead’
‘Just a bit worried about answering all their questions’
‘Have support from manager and admin, so support from team’.
A
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in their own way
if it interests them
building on previous life
experience, knowledge and assumptions
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experientially - practical problem solving
when the process is positive eg an affinity or relationship
to the facilitator.
We
are unaware of what we don’t know
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We
realise that there are things that we
don’t know and seek to learn more
We are unaware or unconfident in
the extent of our knowledge
We are clear and confident of
our knowledge base
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V
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Visual learners
Auditory learners
Reading/writing
preferences
Kinaesthetic/
tactile learners
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Discuss : how we will train others in using ADOM?
10 mins with no expectation of sharing
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m
b
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This is not about your learning style - it is about your students.
Working with different styles:
•
takes time
•
makes for interesting presentations
•
means you can’t please all the people all the time
Adults can take responsibility for their own learning or preferred learning
style.
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pre workshop preparation
during the workshop
post workshop support.
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?
T
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w
o
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k
s
h
o
p
opening
content
wrap up and conclusions.
“
I
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b
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y
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”
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E
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Poll
Evaluation of ADOM training in your services.
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Your ADOM trainer or champion
ADOM key resource people
ADOM refresher e-learning
ADOM Reflections & loomio
ADOM information
www.tepou.co.nz
- ADOM pages
T
H
A
N
K
Y
O
U
Poua ki runga
Poua ki raro
Poua ki tāmore nui
Nō Rangi, nō Papa
E Rongo! He āio!
Pai Mārire!
Training program for addiction practitioners on Alcohol and Drug Outcome Measure (ADOM), providing information on collection and use of ADOM, Information Collection Protocol (ICP), and the ADOM Guide to enhance reporting and practice consistency. The program consists of two modules covering health outcomes, ADOM implementation, use of outcomes information, and training the trainers for effective utilization. Participants engage in discussions, polls, and breakout sessions to deepen understanding and application of ADOM principles.
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Presentation Transcript
Te Pou: our karakia Poua ki runga Poua ki raro Poua ki t more nui N Rangi, n Papa E Rongo! He io! Pai M rire! Establish above and below the connection with the sky and earth and a peaceful environment. Let goodwill and harmony reign!
Alcohol and Drug Outcome Measure (ADOM) training For training addiction practitioners in the reporting and use of ADOM
Objectives of this ADOM training As an ADOM Trainer, you will be: provided with information and resources to support consistent collection and use able to use the ADOM effectively and in accordance with the ADOM Information Collection Protocol (ICP) familiar with and use the ADOM Guide for Addiction practitioners as a resource able to impart this information back to your colleagues or service.
Module 1 There are 2 modules to this training, Module one covers section 1 and 2: Section 1: Background to health outcomes and outcome tools Section 2: Implementing the ADOM WHAT about ADOM WHO? - are eligible services and t ngata whai ora HOW & WHEN - to collect and use the ADOM (ICP)
Module 2 Section 3: Using outcomes information Section 4: Training the trainers to train.
Poll Poll on confidence in training people with ADOM
Section 1 Background to health outcomes
Pre reading Slides were sent to you prior to course, to be read before training. Any questions on these?
Breakout Groups Discussion: What are the differences between inputs, outputs and outcomes Take 10 mins. Very quickly introduce yourselves and then discuss. You will be automatically assigned a group and brought back to the main group
Outcome measures (OM) Outcome definition: an outcome is a change in health, wellbeing and circumstances over time. (Te Pou 2012)
An outcome measure has a: standard set of statements or questions defined points to measure change over a period of time standardised rating system for each statement or question The set of rules for rating the measure is called an Information Collection Protocol (ICP).
Therefore each time the outcome measure is used: the same information is collected in the same way so information collected can compare change over time ( comparing apples with apples ).
New Zealand outcome measures domains and raters Outcome measure identified Outcome domain type Rater The Health of the Nation Outcome scales (HoNOS) suite of outcome measures mandated form 2004 Clinician rated and shared with the t ngata whai ora Symptom severity The Alcohol and Drug Outcome Measure (ADOM) mandated from 1 July 2015 Alcohol and other drug use; Lifestyle, wellbeing and recovery t ngata whai ora rated, practitioner facilitated Hua Oranga M ori mental health outcomes. Voluntary use t ngata whai ora, Wh nau and clinician rated. M ori health T ku Reo T ku Mauri Ora t ngata whai ora outcomes measure for Aotearoa, New Zealand. Voluntary use T ngata whai ora recovery t ngata whai ora rated
Section 2: Implementing the ADOM
Breakout groups Discussion: What does implementing ADOM mean to you? 5 mins to discuss. You won t need to share or feedback to main group
ADOM Guide for addiction practitioners Newest version is always on Te Pou website. Core document for national implementation of ADOM. includes: information about ADOM eligibility criteria information collection protocol (ICP) clinical pathways and collection occasions facilitating ADOM collection Referred to in the document as the ADOM Guide or the Guide .
What is ADOM? ADOM was developed in 2009 (current version 2013) extensive consultation and validation process high interest and demand for an outcomes measure for and from addiction sector ADOM implementation project ADOM finalised and ADOM Feedback Wheel developed Voluntary implementation 2014, mandatory rollout 2015.
Design and intent Refer to: Section 1 - About the ADOM in ADOM Guide for use in adult community-based outpatient addiction services or programmes collaborative process practitioner and t ngata whai ora provides a summary of t ngata whai ora treatment journey demonstrates change over time NOT a clinical tool for screening, assessment or review.
Breakout groups Discussion: What did you take from the video? 5 mins to discuss. You won t need to share with main group
Sections Heading Demographics and identifiers these help identify the context for the data collected Section 1 Q1 Q9 substance use Q10 Q11 - injecting use and/or sharing needles Section 2 Q12 Q17 lifestyle and wellbeing, including health, accommodation, daily activities Q18 criminal or illegal activity Section 3 Q19 and Q20 recovery and goal progression.
Question types Refer: Section 4.5 - Facilitating ADOM collection in ADOM Guide frequency of use Q1 to 7 (excl. Q2), Q10, Q12 to 18 quantity used Q2 and Q 8 prioritise substance(s) of concern Q9 YES and NO Q 11 rating scales Q12 to 18 rating scale - Q19 and 20.
WHO? ADOM eligibility exercise Refer to Section 3 - ADOM eligibility criteria in ADOM Guide Which services are eligible to collect ADOM? Which t ngata whai ora are eligible for ADOM collection?
HOW is ADOM collected? Refer to: Section - Essential training for ADOM clinicians in ADOM Guide Information Collection Protocol (ICP) clinical pathways and collection occasions practitioner role
Information Collection Protocol (ICP) Refer: Section 4.1 Information Collection Protocol in ADOM Guide Following the ICP ensures we collect good quality data from t ngata whai ora who have provided this information. This means practitioners, teams, and services are all collecting the same data and information - when it is used we know we are comparing apples with apples .
ADOM collection occasions ADOM is collected during an episode of care at the following treatment stages: Treatment start (Assessment) ADOM Review ADOM Treatment end (Discharge) ADOM Your ADOM data collection and reporting system may provide a reminder when due.
Clinical pathway and ADOM collection occasions Refer: Section 4.2 in the ADOM Guide for Addiction Clinicians on page 15
Treatment start - ADOM Refer: Section 4.3 - Collection occasions in ADOM Guide Treatment start ADOM Reason for collection/collection date New t ngata whai ora entering service assessment completed. The intention is ongoing treatment with the service. treatment start - New complete ADOM within 2 weeks of treatment start. New t ngata whai ora entering service (referral from other addiction service). Assessment completed. The intention is ongoing treatment with the service. treatment start other AOD service complete ADOM within 2 weeks of treatment start. New t ngata whai ora entering service - assessment indicates referral on to more appropriate service (e.g. residential, detox or mental health), or is not appropriate to service. assessment only complete ADOM within 2 weeks of assessment.
Treatment reviews - ADOM Refer: Section 4.3 - Collection occasions in ADOM Guide Review ADOM Reason for collection/collection date at 6 weeks from the treatment start ADOM. treatment review 6 weeks complete ADOM 2 weeks either side of 6 week review due date. at 12 week intervals, from the last review ADOM . treatment review 12 weeks/3 months complete ADOM 2 weeks either side of 12 week review due date.
Treatment end/discharge - ADOM Refer: Section 4.3 - Collection occasions in ADOM Guide Treatment end ADOM At planned discharge from current episode of care. Reason for collection/collection date treatment end routine complete ADOM within 1 week of treatment end date. t ngata whai ora does not attend planned appointments. treatment end DNA complete ADOM, administrative data only, within one week of treatment end. Other AOD service. treatment end other AOD service complete ADOM within 1 week of treatment end. Other for example t ngata whai ora deceased or other reason that does not fit into categories above. treatment end other complete ADOM, administrative data only, within one week of treatment end.
Breakout Groups Discussion: What are the collection occasions for ADOM 10 mins to discuss. Choose someone in group who can feedback your discussion to main group
Focus of care Identifies the main focus of care provided over the period of care ie 6 or 12 weeks: engagement, screening and assessment active treatment continuing care. What do these terms mean in relation to ADOM?
The practitioner role Refer to: Section 4.5 The clinicians role in ADOM Guide collaborative practitioner introduces and facilitates ADOM collection process motivational approach - positive engagement, listening and non- judgmental feedback ensure a safe confidential environment integrate in to good clinical practice.
Recap Module 1 Background to outcomes Implementing ADOM
Section 3: How can outcomes information be useful?
Successful implementation reminder For data to be useful it needs to become part of every day practice what we do around here This requires: strong leadership planning and phasing of implementation user friendly IT structure and systems training and education quality improvement outcomes coordination - local, regional, national.
Value at different levels T ngata whai ora level Service level National utility
Individual (tngata whai ora and practitioner) utility Informs and shape treatment. There is evidence that feedback improves recovery for clients (Michael Lambert, USA) Assist t ngata whai ora to view progress with their recovery And areas where progress has not occurred or intervention can be offered Service users want to know how they are doing in a more systematic way (AMHOCN) Provides practitioners with a means for reviewing treatment planning and goals with t ngata whai ora.
ADOM outcomes data provides a summary of change during treatment journey for t ngata whai ora covers many important aspects of the t ngata whai ora experience and treatment eg ADOM provide information about: alcohol and drug use individual s lifestyle and wellbeing Individual view of progress and satisfaction.
Making data useful? data collected must be easy to use easy to see what s happening offer benefit to all involved. ADOM feedback wheel provides a means of sharing a visual representation of the service users progress with the t ngata whai ora.
Breakout Group Discussion: What did you take from the video? 5 mins discussion. No expectation on sharing with main group.
How can outcomes information be useful? Ref: Malcolm Stewart PhD P.G. Dip. ClinPsych, Thrive Psychology Limited. National Level Grouped information to understand service users, understand outcomes, and identify best practice Service Level Both of these Team Level Interaction Level t ngata whai ora and practitioner Promoting conversation about individual s goals and outcomes
Number valid ADOM collection by reason for collection and organisation type, July 2020 to June 2021 From Report 11: Source: Ministry of Health, PRIMHD extract 1 November 2021, analysed and formatted by Te Pou.
Distribution of substance of main concern at ADOM treatment start collections, by age group, July 2020 to June 2021 From Report 11: Source: Ministry of Health, PRIMHD extract 1 November 2021, analysed and formatted by Te Pou.
Distribution in lifestyle and wellbeing for ADOM treatment start and end for matched pairs, July 2020 to June 2021 From Report 11: Source: Ministry of Health, PRIMHD extract 1 November 2021, analysed and formatted by Te Pou.
