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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
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A Tipping Point for Measurement-Based Care.

John C Fortney1, Jürgen Unützer1, Glenda Wrenn1

  • 1Dr. Fortney and Dr. Unützer are with Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle (e-mail: fortneyj@uw.edu ). Dr. Fortney is also with the HSR&D Center of Innovation for Veteran-Centered and Value-Driven Care, Puget Sound Veterans Healthcare System, Seattle. Dr. Wrenn is with the Department of Psychiatry, Morehouse School of Medicine, Atlanta. Dr. Pyne and Dr. Smith are with the Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock. Dr. Pyne is also with the HSR&D Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, Little Rock. Dr. Schoenbaum is with the Department of Epidemiology and Economics, Division of Services and Intervention Research, National Institute of Mental Health, Bethesda, Maryland. Dr. Harbin is a consultant in Baltimore.

Psychiatric Services (Washington, D.C.)
|September 2, 2016
PubMed
Summary
This summary is machine-generated.

Measurement-based care, using symptom rating scales, significantly improves patient outcomes when integrated into clinical decisions. This approach is feasible, acceptable, and offers broader system-level benefits.

Keywords:
Health care reformMeasurement-based carePsychiatric assessmentRating scales

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Area of Science:

  • Mental Health
  • Clinical Psychology
  • Health Services Research

Background:

  • Measurement-based care (MBC) systematically uses symptom rating scales to guide individual patient treatment decisions.
  • This review synthesitsizes the theoretical and empirical evidence supporting MBC.

Purpose of the Study:

  • To examine the theoretical and empirical support for measurement-based care.
  • To evaluate the efficacy and feasibility of MBC in clinical practice.

Main Methods:

  • A literature review was conducted using PubMed and Google Scholar.
  • Additional articles were identified through reference checking and expert consultation.

Main Results:

  • Numerous validated symptom rating scales exist.
  • Randomized trials show MBC with frequent feedback significantly improves outcomes.
  • Ineffective strategies include infrequent assessment and delayed feedback.

Conclusions:

  • MBC is effective, feasible for large-scale implementation, and well-accepted by patients and providers.
  • Aggregated MBC data can inform quality improvement, professional development, and payer value assessments.