Measuring the Quality of Mental Health Treatment

This week’s entry is a guest article by Dr. Vince Bellwoar, a psychologist user of our software whose practice is located in Pennsylvania. Vince posted a question on our SOS user group about how other users measure quality of care. This spurred significant discussion on that group. I am hopeful that it will also stir up some discussion here. -Kathy

Our practice has always aspired to provide excellent quality. What business hasn’t? This article is meant to stimulate discussion as how to address and improve the quality of clinical practice.

We emphasize two points in hiring: 5 years of solid clinical work and very good people skills. If we can’t imagine a range of patients connecting with you, we are not hiring you. The next step is to monitor how well the therapist holds patients. Billing software with decent reporting capabilities can be an invaluable resource here.

Patients who stay in treatment tend to get better, and as they improve, they’ll refer others. In contrast, therapists who lose 40% of new referrals by the 3rd session usually are doing so out of errors of omission or commission. Our billing software allows us to mine the data that tells us what percent of new referrals continue with each therapist after the 3rd session. Granted, this is a blunt assessment tool; and so we have searched for other means of assessment.

After my car is in the shop for service, I get a call asking, “How did we do?” We tried something similar with a patient satisfaction survey sent to patients whose last treatment session was more than six weeks ago. (This assumes that a six week break from treatment meant the client was done with treatment for now). Unfortunately, the return rate was only 10% even though we provided stamped return envelopes or used email. Our next attempt will be to put the survey in waiting rooms with large signs encouraging completion. We want to keep the surveys out of the treatment session as many believe this could change the nature of the treatment session.

There are numerous satisfaction surveys out there. I find the ones constructed by insurance companies are particularly bad, not to mention self-serving. They see success as getting patients out of treatment ASAP. We constructed our own survey, yet it doesn’t seem to get at the heart of the matter: what was specifically helpful or not helpful in the therapy session. What did the therapist do (commit) or not do (omit) that made the treatment better or worse?

Our next survey version will pose these open-ended questions. I hope that this will generate the type of quantitative and hearty data that can complement the qualitative data from our billing software—and ultimately be beneficial to therapists.

Our goal is to identify what happens in a therapy session that makes a therapist “good”. Then we can give the therapist concrete, usable feedback that encourages improvement. We want people who are interested in this type of feedback, whether they are a therapist, secretary, psychiatrist, and, yes, even the owner!

I welcome your feedback.

Vince Bellwoar, Ph.D.
http://www.springfieldpsychological.com