Routine measurement of outcomes in Australia's public sector mental health services

OBJECTIVE: This paper describes the Australian experience to date with a national 'roll out' of routine outcome measurement in public sector mental health services. METHODS: Consultations were held with 123 stakeholders representing a range of roles. RESULTS: Australia has made an impressive start to nationally implementing routine outcome measurement in mental health services, although it still has a long way to go. All States/Territories have established data collection systems, although some are more streamlined than others. Significant numbers of clinicians and managers have been trained in the use of routine outcome measures, and thought is now being given to ongoing training strategies. Outcome measurement is now occurring 'on the ground'; all States/Territories will be reporting data for 2003-04, and a number have been doing so for several years. Having said this, there is considerable variability regarding data coverage, completeness and compliance. Some States/Territories have gone to considerable lengths to 'embed' outcome measurement in day-to-day practice. To date, reporting of outcome data has largely been limited to reports profiling individual consumers and/or aggregate reports that focus on compliance and data quality issues, although a few States/Territories have begun to turn their attention to producing aggregate reports of consumers by clinician, team or service. CONCLUSION: Routine outcome measurement is possible if it is supported by a co-ordinated, strategic approach and strong leadership, and there is commitment from clinicians and managers. The Australian experience can provide lessons for other countries.

A Research Agenda for Strategic Management Research in Developing Countries

This paper explores the extent to which it is possible to address issues pertaining to developing countries with significant socio-cultural and political interventions. Examples from the Sri Lankan tea plantations are used to illustrate the necessity to understand the context from actors’ perspectives using rigorous case study research, before making prescriptive recommendations. Current problems faced by the Sri Lankan tea industry are identified as not merely micro-institutional or managerial. We argue that their roots lie in reproduction of social struggles at the level of production. We propose a research agenda, in the doctrine of critical theory, for exploring the formation and implementation of business strategies in developing countries, using the tea plantation sector as a case. Our primary attempt here is to conceptualize strategic management in the context of political economy and to identify central issues to be addressed. Accordingly, we argue that researching historical dynamics of strategic management facilitates understanding and interpreting the articulation of modes of production in a given social formation. We further argue that a highly context specific research agenda is required to fully comprehend idiosyncratic characteristics of Sri Lankan strategy structures and organizational forms. Then, it is proposed that explaining the role of social formation in shaping and reshaping strategy relations should be at the centre of the research due to the social significance attached to ‘strategy’. Finally, methodological and epistemological necessities arising from the nature of strategy relationships are discussed.