Quality indicators for mental health services

Abstract

Assessing the quality of healthcare services is challenging because the concept is multidimensional and difficult to operationalize. One commonly accepted approach is to assess three main constructs: (1) clinical improvement, (2) patient safety, and (3) patient experience of treatment/ care. Clinicians and healthcare providers often conflate indicators of health processes (inputs) with outcomes (outputs). For example, the percentage of people with a specific diagnosis who are offered an appropriate, evidence-based treatment is an indicator of process, whereas a measure showing improvement in symptoms is an outcome. As well as clarifying exactly which outcomes and indicators of safety and patient experience are to be assessed, additional factors have to be taken into account when choosing measures to assess service quality: the availability of relevant data; whether the psychometric properties (reliability, validity) of any standardized measure under consideration are adequate; whether staff will require training to use the measure; whether there is any cost for using the measure; how data collection will be coordinated; how data will be managed (input, cleaned, and collated); and how data will be reported, by whom, and for what purpose/audience. Most of these factors require specific resources and designated systems and individuals in order to collect and report data so that they can be interpreted meaningfully and inform further improvements to services.