Improving Quality Outcomes in Veteran-Centric Care

Area of Science:

• Psychiatric Nursing
• Mental Health Services Research
• Quality Improvement in Healthcare

Background:

• The University of Alabama at Birmingham (UAB) School of Nursing and the Birmingham Veterans Affairs Medical Center (BVAMC) established a Psychiatric-Mental Health Nurse Practitioner (PMHNP) Residency Continuity Clinic.
• The clinic aimed to deliver Veteran-centric outpatient mental health treatment utilizing measurement-based care (MBC).

Purpose of the Study:

• To evaluate the effectiveness of MBC in improving mental health outcomes for Veterans.
• To assess the impact of PMHNP residents' use of MBC on patient depression and anxiety levels.

Main Methods:

• PMHNP residents administered the Patient Stress Questionnaire (PSQ), an MBC tool, to Veterans from March to August 2016.
• The PSQ incorporates validated instruments for depression, anxiety, PTSD, alcohol use, and pain assessment.
• Retrospective analysis of PSQ scores used descriptive statistics, paired t tests, and Wilcoxon signed ranks tests.

Main Results:

• Analysis indicated improvements in patient depression and anxiety scores that approached statistical significance.
• The study observed positive trends in several national Veterans Affairs mental health performance measures.
• These findings underscore the value of MBC in psychiatric assessment and treatment.

Conclusions:

• Measurement-based care (MBC) is a valuable approach for enhancing mental health outcomes in Veteran populations.
• The implementation of MBC within a PMHNP residency program shows potential for quality improvement in psychiatric outpatient care.
• Continued use of MBC tools can guide clinical decision-making and improve the quality of mental health services for Veterans.