Oral 9

[O-9-04] Measuring What Matters: Patient Centered Outcome Measures of Goal-Directed Care for People with Serious Mental Illness

*Joshua Breslau¹, Caroline Blaum², Nev Jones³ (1.RAND Corporation(United States of America), 2.National Committee for Quality Assurance(United States of America), 3.University of Pittsburgh(United States of America))

Keywords:

Outpatient Psychiatry,Quality Measurement,Person-Centered Care

Measurement of the quality of mental health care can help guide improvements in care, but existing measures do not assess how well care addresses needs as perceived by patients. Patient-centered outcomes measures are a potential strategy for filling this gap. This ongoing study is developing quality measures that assess how well care for adults with serious mental illness is helping service users to attain goals that are important to them. The measures use an approach called Goal Attainment Scaling (GAS), which combines personalization of goals with standardization of measurement. In GAS, clinicians work with their clients to identify a goal and create a personalized scale for measuring progress toward that goal. Clinicians are trained to help clients develop attainable goals based on their values and preferences. Progress towards the goal is then assessed at follow-up meetings within 2 to 6 months. GAS has been used in long term care for the elderly and is being adapted for use in serious mental illness care. This paper presents preliminary quantitative and qualitative findings from five integrated behavioral health clinics in Texas and Arizona, where the measures are being implemented. Preliminary findings indicate successful introduction of the measures into practice, with potential limitations in long-term follow-up that should be addressed in future work. Clinic administrators and case managers report effective integration of the measures into routine care and advantages over prior approaches to goal-setting. In particular, the ability to focus on realistic, concrete, measurable progress towards attainable goals is perceived as an advantage over prior approaches, which focused on more general goals without clearly defined criteria for progress. The approach shows promise, but may need additional adaptation to the use in behavioral health care.