Incorporating Results of a Provider Attitudes Survey in Development of an Outcomes Assessment Program

Abstract

The objective of this study was to obtain information from providers of a behavioral health service and from decision makers for organizations interacting with that service (external contacts) on their attitudes regarding outcomes assessment in their clinical practice. The goal of obtaining the information was to use it in development of a formal Outcomes Assessment Program for the service. The design was a semi-structured interview format, with entry into a computer database and qualitative analysis of responses obtained. Participants included all providers (n = 26) and a purposive sample of external contacts (n = 10) of an academic Department of Psychiatry. Results indicated differences among categories of external contacts regarding priorities of types of outcomes (general health, general mental health, disorder specific, or patient satisfaction) to be shared and absence of concordance within the service about these priorities. No guidelines were available about preferred instruments, though the Global Assessment of Functioning, the Beck Depression Inventory, and the Abnormal Involuntary Movements Scale emerged as instruments to be prioritized in the service's program. Physicians and nonphysicians differed in their perceptions as to important barriers and advantages of a clinical outcomes assessment program. In conclusion, the survey raised providers' awareness of outcomes assessment and provided information that was used in developing the service's Outcomes Assessment Program. Components of the Program that were influenced by survey input were priorities of outcomes instruments to be included and their potential audiences, time sequence of Program development, time to be allotted to outcomes assessment in clinical encounters, and content of educational experiences for providers.

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References

Bologna NC , Feldman MJ . Using outcomes data and clinical process redesign: improving clinical services. Behav Healthc Tomorrow 1995;4(6):59-65.

Smith GR , Waxman H , Snyder D , et al. Assessment tools in psychiatry. Amer J Med Qual 1996;11:S46-S49.

Britton JW , Wood DW . Developing a customized outcomes program. Behav Healthc Tomorrow 1995;4(2):53-56.

Smith GR , Fischer EP , Nordquist CR , et al. Implementing outcomes management systems in mental health settings. Psychiatr Serve 1997;48:364-368.

Berman WH , Hurt SW . Talking the talk, walking the walk. Implementing an outcomes information system. Behav Healthc Tomorrow 1996;5(3):39-43.

Conway AC , Keller RB , Wennberg DE . Partnering with physicians to achieve quality improvement. Jt Comm J Qual Improv 1995;21:619-626.

Russek L , Wooden M , Ekedahl S , et al. Attitudes toward standardized data collection. Phys Ther 1997:77:714-729.

Schuster JM , Kern EE , Kane V , et al. Changing roles of mental health clinicians in multidisciplinary teams. Hosp Commun Psych 1994;45:1187-1189.

Srebnik D , Hendryx M , Stevenson J , et al. Development of outcome indicators for monitoring the quality of public mental health care. Psychiatr Serv 1997;48:903-909.

10.

Kvale S . Interviews. An Introduction to Qualitative Research Interviewing. Thousand Oaks, CA: Sage, 1996.

11.

US General Accounting Office . Using Structured Interviewing Techniques (Transfer Paper 10.1.5). Washington, DC: US General Accounting Office, Program and Methodology Division, 1991.

12.

Seidman IE . Interviewing as Qualitative Research. A Guide for Researchers in Education and the Social Sciences. New York: Teachers College Press, 1991.

13.

Ware JE . The MOS 36-item short-form health survey (SF-36). In: Sederer LI , Dickey B , eds. Outcomes Assessment in Clinical Practice. Baltimore: Williams and Wilkins, 1996:61-64.

14.

Spitzer RL , Gibbon M , Williams JBW , et al. Global assessment of functioning (GAF) scale. In: Sederer LI , Dickey B , eds. Outcomes Assessment in Clinical Practice. Baltimore: Williams and Wilkins, 1996:76-78.

15.

Eisen SV . Behavior and symptom identification scale (BASIS-32). In: Sederer LI , Dickey B , eds. Outcomes Assessment in Clinical Practice. Baltimore: Williams and Wilkins, 1996:65-69.

16.

Steer RA , Beck AT . Beck Depression Inventory (BDI)™). In: Sederer LI , Dickey B , eds. Outcomes Assessment in Clinical Practice. Baltimore: Williams and Wilkins, 1996:100-104.

17.

Grebb JA . Psychiatric rating scales. In: Kaplan HI , Sadock BJ , eds. Comprehensive Textbook of Psychiatry. Vol. 1. 5th ed. Baltimore: Williams and Wilkins, 1989:534-552.

18.

Andreasen NC , Black DW . Introductory Textbook of Psychiatry 2nd ed. Washington, DC: American Psychiatric Press, 1995:721-722.

19.

Health Care Financing Administration . HCFA restructures to serve customers better. Available at: www.hcfa.gov/reorg.htm. Accessed July 29, 1997.

20.

National Committee for Quality Assurance . Standards for the Accreditation of Managed Behavioral Healthcare Organizations. Annapolis Junction, MD: NCQA Publications, 1997.

21.

Joint Commission on Accreditation of Healthcare Organizations . Comprehensive Accreditation Manual for Managed Behavioral Health Care. Oakbrook Terrace IL: JCAHO Publications, 1997.