Monitoring outcomes as a quality improvement strategy, better described as systematic client feedback, is no longer a vision of the distant future—it is the way things are expected to be done quite soon in the case of the Joint Commission and now in the case of the Council on Accreditation. Here are some excerpts from the standards of these two huge accrediting bodies with my comments in italics afterwards. But my first comment is, “It’s about time!” Visit https://www.jointcommission.org/assets/1/18/BHC_Outcome_Measures_Jul2017_Prepub.pdf and http://coanet.org/standard/pqi/4/ to download the standards.
The organization assesses the outcomes of care, treatment, or services provided to the individual served.
1. The organization uses a standardized tool or instrument to monitor the individual’s progress in achieving his or her care, treatment, or service goals. Note: Ideally, the tool or instrument monitors progress from the individual’s perspective. Not, ideally, but rather it’s the only way that makes sense! PCOMS and BON are built to accomplish this and the desire to privilege client perspectives is what started PCOMS. And of course, the PCOMS measures are psychometrically validated by us and independent researchers.
2. The organization gathers and analyzes the data generated through standardized monitoring, and the results are used to inform the goals and objectives of the individual’s plan for care, treatment, or services as needed. Client response to services represents the main informant of care. The consumer’s benefit or lack thereof determines the next steps in the therapeutic process. PCOMS and BON are built to accomplish results-driven goals and objectives via involving consumers in all decisions that affect their care.
3. The organization evaluates the outcomes of care, treatment, or services provided to the population(s) it serves by aggregating and analyzing the data gathered through the standardized monitoring effort. Collecting PCOMS data allows the effectiveness of an organization to be truly known at the provider, program, and agency levels. It provides for an ongoing quality improvement strategy to monitor outcomes and make program changes to better serve consumer needs. Better Outcomes Now is built with unlimited data aggregation and analyses possibilities as well as the ongoing assessment of improvement over time.
Council on Accreditation (COA)
COA’s Performance and Quality Improvement (PQI) standards encourage organizations to use data to identify areas of needed improvement and implement improvement plans in support of achieving performance targets, program goals, client satisfaction, and positive client outcomes. This sounds like COA is preaching the PCOMS gospel!
Organizations are encouraged to use standardized or recognized outcomes evaluation tools when such tools are available and appropriate. Using a standardized tool increases the likelihood that the measurement process will give the organization a true picture of client progress and program impact. Using a standardized tool also makes it easier to compare a program’s results with the results of other programs using the same instrument. Reiterating, PCOMS’ measures are widely established to be psychometrically (reliability and validity) sound not only in English, but Norwegian, Dutch, and now, Chinese.
The organization systematically collects, aggregates, analyzes, and maintains data. PQI data management procedures should be part of the organizations overall data management procedures/guidelines. BON is built to make data management simple and accessible to everyone, from consumers to CEOs. And, quality improvement is part and parcel to the way the data are analyzed and presented.
The organization analyzes PQI data to:
a. track and monitor identified measures;
b. identify patterns and trends;
c. compare performance over time;
d. compare data against the results of internal benchmarks; and
e. compare data against the results of external benchmarks, if available
Again, it sounds like the guidelines were written with PCOMS/BON in mind. BON delivers on all counts.
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