Using Organizational and Clinical Performance Data to Increase the Value of Mental Health Care

U.S. health systems, policy makers, and patients increasingly demand high-value care that improves health outcomes at lower cost. This study describes the initial design and analysis of the Mental Health Management System (MHMS), a performance data and quality improvement tool used by the Veterans H...

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Bibliographic Details
Published in:	Psychological services Vol. 14; no. 1; pp. 13 - 22
Main Authors:	Schmidt, Eric M, Krahn, Dean D, McGuire, Marsden H, Tavakoli, Sara, Wright, David M, Solares, Hugo E, Lemke, Sonne, Trafton, Jodie
Format:	Journal Article
Language:	English
Published:	United States Educational Publishing Foundation 01-02-2017 American Psychological Association
Subjects:	Clinical outcomes Disease management Health care access Health Care Administration Health care expenditures Health planning Health Services Accessibility - economics Health Services Accessibility - organization & administration Health Services Accessibility - standards Health status Human Humans Medical Informatics Applications Mental health care Mental health professionals Mental Health Program Evaluation Mental Health Services Mental Health Services - economics Mental Health Services - organization & administration Mental Health Services - standards Military hospitals Military Veterans Organizational effectiveness Organizational structure Outpatient Patient satisfaction Patients Policy making Psychiatrists Psychosocial factors Quality Improvement - economics Quality Improvement - organization & administration Quality Improvement - standards Quality management Quality of Care Staffing Treatment methods United States United States Department of Veterans Affairs - economics United States Department of Veterans Affairs - organization & administration United States Department of Veterans Affairs - standards Vacancies Value Veterans veterans mental health services organization and administration quality indicators program evaluation quality improvement
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Summary:	U.S. health systems, policy makers, and patients increasingly demand high-value care that improves health outcomes at lower cost. This study describes the initial design and analysis of the Mental Health Management System (MHMS), a performance data and quality improvement tool used by the Veterans Health Administration (VHA) to increase the value of its mental health care. The MHMS evaluates access to and quality of mental health care, organizational structure and efficiency, implementation of innovative treatment options, and, in collaboration with management, resource needs for delivering care. Performance on 31 measures was calculated for all U.S. VHA facilities (N = 139). Pearson correlations revealed that better access to care was significantly associated with fewer mental health provider staffing vacancies (r = −.24) and higher staff-to-patient ratios for psychiatrists (r = .19) and other outpatient mental health providers (r = .27). Higher staff-to-patient ratios were significantly associated with higher performance on a number of patient and provider satisfaction measures (range of r = .18-.51) and continuity of care measures (range of r = .26-.43). Relationships observed between organizational and clinical performance measures suggest that the MHMS is a robust informatics and quality improvement tool that can serve as a model for health systems planning to adopt a value perspective. Future research should expand the MHMS framework to measure patient and health systems costs and psychosocial outcomes, as well as evaluate whether quality improvement solutions implemented as a result of using organizational information leads to higher-value mental health care.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1541-1559 1939-148X
DOI:	10.1037/ser0000098