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Clinical Decision Support Tool: A rational needs-based approach to making clinical decisions

Background: In a specialist Mental Health Trust in the North of England there appeared to be idiosyncratic referral pathways and care packages, and conflicting views on clinical priorities. A brief review of the literature suggested that this was a national problem. Aims: To describe the development and initial evaluation of a system of needs-based consistent but flexible care packages. Method: A participatory action research approach was adopted. Through an iterative process staff at all levels explored current clinical practice, and took part in data collection and collation, and consensus building around the assessment of needs and appropriate service responses. A shared vocabulary was developed, covering assessment of needs, aims of interventions and activities of interventions. Results: The project developed a Clinical Decision Support Tool (CDST), with acceptable concurrent validity. It allows for service users to be allocated to clusters on the basis of shared needs and points to care packages linked to needs. Conclusions: The CDST provides an empirically based framework linking care packages to needs. It conveys professional understandings and assessments during care planning in a way that is accessible to people from a range of professional backgrounds, and service users and carers. It underpins the CPA process, and is increasingly the basis for care plans. Detailed information systems are now being developed for the CDST to inform service planning and commissioning decisions. Declaration of interest: None.