A Clinical Leadership Lens on Implementing Progress Feedback in Three Countries: Development of a Multidimensional...

Area of Science:

• Implementation Science
• Mental Health Services Research
• Qualitative Research Methods

Background:

• Progress feedback, or measurement-based care (MBC), is crucial for improving mental health care but faces challenges in sustained implementation.
• Barriers and facilitators to MBC integration exist at patient, clinician, organizational, and health system levels.
• A common language is needed to address these implementation challenges effectively.

Purpose of the Study:

• To develop a qualitative coding scheme for progress feedback implementation.
• To account for dynamic barriers and facilitators across multiple levels in mental health settings.
• To provide a tool for researchers and implementers to identify and address implementation factors.

Main Methods:

• Semi-structured interviews were conducted with clinical staff, managers, and leaders across international mental health organizations.
• Interviews explored intra- and extra-organizational characteristics influencing progress feedback use.
• A team-based consensus approach refined an a priori coding scheme using a hermeneutic, second-order axial coding method.

Main Results:

• An empirically derived, multi-level qualitative coding scheme was developed.
• The scheme includes nine superordinate categories and 30 subcategories.
• Contextually sensitive categories for barriers and facilitators were established.

Conclusions:

• The developed coding scheme offers a standardized approach for progress feedback implementation research.
• The scheme is applicable across diverse contexts and settings, with potential for refinement.
• The study provides guidance for future research and practical application in mental health settings.