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Improving Mental Healthcare
A Guide to Measurement-Based Quality Improvement
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Richard C. Hermann, M.D., M.S.
The first book
to focus on measuring the basic processes of mental healthcare,
such as access, detection, treatment appropriateness, safety and
continuity of care, Improving Mental Healthcare: A Guide to Measurement-Based
Quality Improvement integrates practical information about quality
measures—such as their clinical logic, validity and basis in
scientific evidence—into a highly readable guide on how to
implement measures and use the results to improve quality of care.
Improving Mental
Healthcare examines the clinical, policy, and scientific underpinnings
of process measurement, a widely used method of assessing quality
of mental healthcare. It describes the use of measurement to improve
quality, promote accountability, encourage evidence-based practice,
and shape incentives to favor delivery of high-quality care.
Divided into
two sections totaling 14 chapters, the first section describes factors
that led to a nationwide emphasis on improving quality of care,
major approaches to quality assessment, considerations in selecting
measures, as well as how to analyze and interpret measure results.
The second section summarizes information on more than 300 quality
measures, including their clinical rationale, specifications, sources
of data, supporting evidence, readiness for use, and—where
available—data on reliability, validity, results, case-mix
adjustment, standards, and benchmarks.
Improving Mental
Healthcare helps clinicians, managers, administrators, payers, purchasers,
accreditors, consumer groups, and other stakeholders meet national
mandates to assess and improve quality of care by providing the
following tools and guidance:
- Results
from the National Inventory of Mental Health Quality Measures,
a federally funded study summarizing clinical, technical, and
scientific properties of more than 300 process measures
- A user-friendly
format that helps potential measure users find quality measures
that reflect their priorities and meet their needs
- Guidance
for healthcare organizations and clinicians on how to integrate
measurement into a comprehensive approach to quality management
- An understanding
of the relationship between process measurement and other approaches
to quality assessment, including assessment of outcomes, treatment
fidelity and interpersonal aspects of care
Improving Mental
Healthcare, which includes extensive references as well as useful
figures and tables illustrating key concepts, is essential reading
for practicing clinicians, healthcare managers, medical students
and psychiatric residents—who must now meet ACGME requirements
to learn about quality assessment and improvement—as well as
members of oversight organizations and consumer advocacy groups.
It will prove invaluable for healthcare organizations seeking to
improve quality of care, clinical training programs, and courses
on quality assessment, healthcare management, and mental health
policy.
Contents
Preface
by Darrel A. Regier, M.D. .........................................................................................................................................................................................................
Section I: Role of Process Measures in Quality Assessment and
Improvement.
Quality assessment and improvement in a changing healthcare system.
Measuring clinical and administrative processes of care.
Selecting process measures.
Comparing and interpreting results from process measurement.
Role of measurement in quality improvement. ..............................................................................................................................................................................
Section II: National Inventory of Mental Health Quality Measures.
Guide to inventory data. Prevention measures. Access measures. Assessment
measures. Treatment measures. Coordination measures. Continuity
measures. Patient safety measures.
Appendix: Directory of measure developers and users.
Author:
Richard C. Hermann, M.D., M.S., is Associate Professor of Medicine
and Psychiatry at Tufts University School of Medicine, Director
of the Center for Quality Assessment and Improvement in Mental Health
(www.cqaimh.org)
at Tufts-New England Medical Center’s Institute for Clinical
Research and Health Policy Studies, and Adjunct Associate Professor
of Health Policy and Management at Harvard School of Public Health.
Reviews
“This
outstanding book provides a comprehensive framework for the use
of quality indicators within the context of quality improvement
initiatives in real practice. Dr. Hermann provides for the field
a comprehensive set of measures in use in practice, as well as research
studies, during an active period of development of the quality of
care and quality improvement field. The book integrates a thorough
understanding of the practical uses of quality measurement with
an understanding of the market context for their use, and standards
for acceptable measures that can span practice and research. The
book is the most comprehensive book available on quality measurement,
from a practical perspective, in the field.”—Ken
Wells, M.D., M.P.H., Professor, David Geffen School of Medicine
and UCLA School of Public Health; Senior Scientist of the Semel
Institute and RAND
“At last
mental healthcare gets serious attention in the quest for higher
quality of care! Improving Mental Healthcare: A Guide to Measurement-Based
Quality Improvement by Richard Hermann is packed with valuable information.
Readers whose primary focus is not on mental health will learn much
in general about quality measurement and improvement in healthcare.
The opening chapters sweep from details of methodology to broad
principles and strategies for quality improvement. The later chapters
capture precise details of an inventory of quality measures for
mental healthcare. Together with writing that flows so smoothly
throughout, I cannot think of a better introduction to quality in
healthcare. A feast indeed!”—R. Heather Palmer M.B.B.Ch.,
S.M., Professor of Health Policy and Management, Director of the
Center for Quality of Care Research and Education, Harvard School
of Public Health
“Author
Richard Hermann has put together an amazingly complete compilation
of well referenced methods and instruments for measuring quality
of care in psychiatry, mental health, and substance abuse. This
work creates neat order out of what had been a chaotic jumble. This
book provides solid ammunition for these related fields to defend
their worth against both a needy but unconvinced and disbelieving
public, and the bean counters simultaneously. A magnificent and
exhaustive, definitive and detailed organized tabulation of ways
to measure the quality of care in mental health, whether or not
it works, is improving or not, and how you can tell.”—George
D. Lundberg, M.D., Editor in Chief, Medscape General Medicine
"This
guidebook fills a gap in the professional literature for those of
us who design behavioral health delivery systems and measure progress.
While the scope is encyclopedic in conveying the history and processes
of measurement available, the content is well organized so that
the reader can go easily and directly to the area of interest. I
know that we will be regularly thumbing through Dr. Hermann's book
for guidance and information as we continue to chart our future
course."—Michael P. Quirk, Ph.D., M.S., Director
Behavioral Health Services, Group Health Cooperative of Puget Sound,
Seattle, Washington
"Improving
the quality of care for persons with mental disorders challenges
all of us, whether we are involved in the delivery of care or are
one of the millions who receive or have loved ones who receive mental
health care. Once the commitment has been made to focus on quality,
the immediate challenge is, how? For those who have made this commitment,
Improving Mental Healthcare offers a wealth of tools on how to assess
quality, the first step in quality improvement."—Anthony
F. Lehman, M.D., M.S.P.H., Professor and Chair, Department of Psychiatry,
University of Maryland, School of Medicine, Baltimore, Maryland
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