Developing Tools for Assessing Quality Activities and Influences
Principal Investigator: Curtis McMillen, PhD, Co-PI
Funder: CMHSR funded pilot (through NIMH - P30 MH068579)
Timeframe: 04/05-07/06
Affiliation: Center for Mental Health Services Research (CMHSR)
Project Staff: Curtis McMillen, PhD, Co-PI
Kraig Knuudsen, Ph.D., Co-PI, Post-doctoral Research Associate
Carol Wods, Ph.D., Consultant
Bethany Lee, MSW and NIMH pre-doctoral trainee
Participating Organizations: Missouri Department of Mental Health (DMH)
Project Contact: Bethany Lee, MSW, (314) 935-6447, ext #2
Project Update as of 4/20/05:
Stage: Completed.
Description: As a result of failed quality improvements efforts in medical care, the Institute of Medicine and others have called for more attention to organizational aspects that contribute to quality and the need for organizational transformations to occur alongside structural changes in order to successfully improve quality. Some organizations, because of their structures, processes and cultures are better able to deliver quality services than other organizations. Measures are needed to tap the key aspects of organizations that make them more or less able to deliver quality services.
This study is the second stage of a three stage measurement development project. The first phase was conducted in late 2004 in the Assessing Actions to Assure (AAA) Quality Study. In it 277 masters degree level GWB practicum instructors completed a written, mailed questionnaire that included preliminary versions of a measure of quality directed activities, barriers to quality service delivery and demands for quality service. These measure included a measure of Quality Directed Activities (QDA), measure of Organizational Capacity to Deliver Quality Services, and a measure of Perceived Demand for Quality Services (PDQ). Each measure was then revised based on the findings of the first phase.
During the current phase of the study the investigators will continue to develop the above measures through consultation on the construction of the measures, completion of the measures by mental health professionals to assess test-retest reliability, and through data analysis.
The specific aims of the project are to further develop:
1. A measure of quality directed activities, an assessment of the amount and type of quality monitoring,
assurance and improvement activities in which a mental health or social service organization is engaged.
2. A measure of an organization's capacity to deliver quality services; and
3. Measures of external demands for quality service delivery perceived within a mental health organization.
Progress in ACISR Year 1, 9/22/05-7/31/05: The team is actively planning implementation and awaiting Human Subjects Approval from Washington University's Internal Review Board (IRB).
Plans for ACISR Year 2, 8/01/05-7/31/06: A subsequent RO1 study will be conducted to further validate the QDA, Organizational Capacity and PDQ instruments and to examine organizational factors related to quality service. Analysis will focus on establishing whether the organization measures of Quality Direct Activities, Organizational Capacity to Deliver Quality Care and Perceived Demands for Quality are associated with different indicators of quality.