NRI developed and standardized the measurement of indicators for diverse performance areas: access to care, appropriateness of care, quality of care, and outcomes of care. Measures applied across the continuum of care – inpatient to outpatient. A formal framework ensures everyone is on the same page. In addition, NRI strives to ensure equal voice to all stakeholders from consumers to clinical staff to administrators.
The Framework:
- Start with a clear statement of the utility of a measure
- Ensure link to how measure impacts care and outcome
- Define clearly and specifically all pieces of data, including data source
- Define population at risk – who benefits from this measure if practice is monitored
- Define the “best-practice” (or preferred practice if science is limited)
- Determine how to count when the best-practice has been used
- Provide criteria for an optimal or maximum performance level
- Define appropriate comparison group, fully understanding group composition and limitations
The Outcome of the Framework:
Measures must be assessed for feasibility. The burden of implementing these measures must be weighed against the benefits that they provide to the organization. NRI has assisted states agencies, professional organizations, and providers in their movements toward meaningful performance measurement metrics and the improvement of their quality of care.
Measures used to hold organizations accountable must balance Clinically Relevant Indicators and Consumer-focused Outcomes. Measures are viewed as a set or to build a dashboard where various aspects of care along with indicators of structural supports can be assessed together to determine the overall functioning of the system.
Benchmarking performance, determining optimal performance levels, and establishing best practices allow for state mental health agencies to promote a high quality of care and improve outcomes for persons served by the public mental health system.