GRiST explicitly models structured clinical judgements of mental-health experts
- based on expertise obtained from multidisciplinary mental-health clinicians
- where rigorous research methods were used for eliciting consensual clinical expertise
- with a clear audit trail demonstrating the evidence base for the risk model
GRiST is a validated model of hierarchical risk expertise which
- links risk data to top-level risks through intervening concepts
- provides a precise formal structure and location for each piece of service-user data
- acts as an index to risk information held in other patient documentation to facilitate its linkage and collation
- has potential to populate information in other patient records and avoid double data entry
- makes it easy to find any piece of information and format it for reports
GRiST integrates empirical evidence with structured clinical judgements
- within a single system
- using the accumulating database of risk data and judgements
- in accordance with Department of Health guidance
GRiST is underpinned by a database with statistical and pattern
recognition tools. On-going analyses will contribute to the research evidence base about
- how clinicians assess risk
- social patterns and inequalities associated with risk assessment
- risk prediction
GRiST was developed from the start to exploit the semantic web with
- flexible formatting of information
- multiple delivery modes and web-based interfaces
- easy and universal access
- ongoing resources for rapid adaptation in response to changing clinical
needs, government directives, and IT requirements
GRiST is designed as an interactive tool with sophisticated interface functionality with
- streamlined data entry with questions displayed only when relevant
- no need to re-enter data that will not change (i.e. persistent/historical
data) for subsequent patient assessments (e.g. date of first suicide attempt) - automatic output of reports from the data entered that can be individually
customised for the particular clinical service - the facility to add comments or narrative to any piece of risk data or to
contextualise risk judgments
GRiST has versions for different populations
- based on the same validated underlying knowledge structure
- where data are easily passed between population groups, currently including:
- working-age adults
- CAMHS
- older adults
- service users for self assessment
GRiST is based on psychological knowledge structuring and reasoning processes,
which enables risk advice to be explained in ways that are
- easy to understand
- easy to validate
- supporting judgements, not blind faith
GRiST is explicitly intended to support shared decision making and self-assessment
- via a service-user version
- as it is accessible via IAPT, primary care, and other front-line services or public
facilities such as libraries and mental-health charities
GRiST represents a common risk language with multiple interfaces for collecting
information and providing advice that
- reflects the needs of different assessors in different contexts
- is all linked to the same underlying model of risk
GRiST provides a whole (health and social care) system approach to risk
assessment that aids risk communication across the entire care pathway, from the community
to specialist secondary mental-health services. It supports conncection between
- different services
- different care sectors
- clinicians, service users and their carers
GRiST creates opportunities for NHS organisations to collaborate on research
projects with the GRiST R&D teambecause it is
- based in two research-intensive universities (Warwick and Aston)
- founded on the philosophy of generating rigorous research
evidence for its development coupled with extensive clinical testing at the point of care