Quality Improvement

In both the public and private healthcare sectors, there is a push to encourage the use of performance measures as a means of improving healthcare quality, which has been found to be lacking by several high profile reports such as the Institute of Medicine’s To Err is Human (2000); Crossing the Quality Chasm (2001); and Improving the Quality of Health Care for Mental and Substance-Use Conditions (2006). A clinical performance measure delimits an aspect of clinical care such as patient outcome, patient experience of care, or clinical process (adherence to evidence-based guidelines specific activities such as diagnosis, assessment, and treatment). Physician-level performance measures are incorporating into healthcare in a number of ways, including: physician-initiated practice review and quality improvement; financial incentives from healthcare payers tied to performance (i.e. pay-for-performance or P4P); board certification; and, public recognition of physicians based on performance. Several concerns about performance measurement have been raised. Field testing of measure validity and reliability is not always thorough. Evidence that performance measurement improves quality care is still limited. Overlapping, redundant measures from multiple initiatives may introduce extra administrative burden for clinicians and their staff. It is important that Psychiatry remain abreast of and involved in performance measure activities to ensure that these efforts are clinically sound and reflect the values of the field.

Given the current emphasis on performance measures, it is important that APA members are knowledgeable and actively involved to ensure that measures reflect the values of psychiatry. APA entities such as the Department of Quality Improvement and Psychiatric Services (QIPS), Department of Government Relations (DGR), and Department of Healthcare Systems and Financing (HSF) will continue to collaboratively monitor and participate in national performance measure initiatives; explore performance measure development and implementation support within the APA; and work with experts such as those involved with Practice Guideline development to ensure that performance measures developed by outside groups are evidence-based and practical.

A Performance Measures spreadsheet and related tables are in final development. This is a comprehensive collection of performance measures that pertain to mental health. Performance measure opportunities that are in existence and/or open for participation will also be posted to this site, as well as a summary of nationally based organizations that provide support in developing or promoting the use of performance measures.