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Addiction Severity Index (ASI)
Family Burden Interview Schedule/Short Form (FBIS/SF)
SF-12
Treatment Services Review (TSR)
Washington Circle Adult Substance Abuse Performance Measures

Introduction

Over the past 10 years, payers have increasingly demanded more accountability and evidence of positive clinical outcomes. Various stakeholders—including insurance companies, the Federal Government (Medicaid and Medicare), and businesses in the public and private sectors—all want to know that their employees and beneficiaries are getting better and that functional status has improved because of treatment and the outlay of benefit dollars. In addition, they want more information about the effects of treatment (e.g., improvements in general health status, improvements in work performance) on their employees beyond utilization, costs, and satisfaction with services. Performance measurement plays a critical role in meeting the accountability demands of various stakeholders.

A system of performance measurement must be a component of an organization's overall quality strategy. The strategy must conform to healthcare quality, defined as "the degree to which health services for individuals and populations increase the likelihood of desired healthcare outcomes and are consistent with current professional knowledge" (Committee to Design a Strategy for Quality Review and Assurance in Medicare, 1990, p. 4).

In addition, the performance measurement system should conform to an accepted healthcare quality framework. The Institute of Medicine (IOM), in its work on developing a framework for a national report card (CNQRHCD, 2001), developed four components of healthcare quality: safety, effectiveness, patient-centeredness, and timeliness (p. 7). These are taken from the six specific aims for healthcare improvement proposed by the IOM Committee on Quality of Health Care in America (CQHCA, 2001). (See Figure 1.)

A performance measurement system is defined as "an entity consisting of an automated database that facilitates performance improvement in healthcare organizations through the dissemination and collection of process and/or outcome measures of performance. Measurement systems must be able to generate internal comparisons of organization performance over time and external comparisons of performance among participating organizations at a comparable time" (JCAHO, 1998).

Performance measurement systems have been developed and implemented in managed care organizations and clinical programs (large and small group practices, mental health clinics, staff model health maintenance organizations) and by purchasers themselves. Treatment staff members can use performance results to monitor and improve outcomes, processes of care, quality of care, accountability, satisfaction and perception, and values determination.

For providers and program administrators, performance measurement systems will provide the opportunity to benchmark with local, state, and national norms and best practices and to conduct comparative analyses within and among clinics. Providers will be able to assess the effects of treatment interventions on health-related quality of life. Data will be analyzed to inform clinical care; clinic-level data could inform the development and refinement of the overall treatment program. Furthermore, local, state, and national data could serve as a resource for clinics across the country and for health services researchers interested in methadone treatment.

Click here for a list of performance measurement sets

References

Committee on Quality of Health Care in America (CQHCA), Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academy Press.

Committee on the National Quality Report on Health Care Delivery (CNQRHCD), Board on Health Care Services. (2001). Envisioning the national health care quality report. Washington, DC: National Academy Press.

Committee to Design a Strategy for Quality Review and Assurance in Medicare, Institute of Medicine. (1990). Medicare: A strategy for quality assurance, Vol. 1. Washington, DC: National Academy Press.

Joint Commission on Accreditation of Healthcare Organizations (JCAHO). (1998). Glossary of terms for performance measurement systems. Retrieved December 2, 2005, from www.jcaho.org/pms/reference+materials/glossary.htm