General Approaches

V. Key Issues: Population Health >> H. Quality/Satisfaction >> General Approaches (last updated 9.24.15)
  • Evidence-Based Medicine
  • Pay-for-Performance
  • Disease Management
  • Routine Outcome Monitoring Refers to regular measurements of patients’ progress in clinical practice, using standardized instruments, aiming to evaluate and, if necessary, adapt treatment aiming to evaluate and, if necessary, adapt treatment. Patients are invited to fill out questionnaires at the beginning of treatment, during treatment and at the end of treatment. Subsequently, clinicians are provided with feedback about their patients’ response to treatment. Based on the feedback, clinicians can make decisions on continuing, altering or terminating treatment. Feedback focuses on the gap between the desired and actual results of care, and possible associated factors, that are within the control of the health care provider.
    • The Verdict is “In”: Feedback is NOT enough to Improve Outcome. “Nearly three years have passed since I blogged about claims being made about the impact of routine outcome monitoring (ROM) on the quality and outcome of mental health services…Well, the verdict is in: feedback is not enough to improve outcomes. Indeed, researchers are finding it hard to replicate the medium to large effects sizes enthusiastically reported in early studies, a well-known phenomenon called the ‘decline effect,’ observed across a wide range of scientific disciplines…in order to realize the potential of feedback for improving the quality and outcome of psychotherapy, emphasis must shift away from measurement and monitoring and toward the development of more effective therapists.” (Miller, Scott, 9.21.15)

Links

  • AHRQ. TalkingQuality. Guidance for sponsors of consumer reports on health care quality

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