Schizophrenia Clinical Trial
Official title:
Using Clinical Process Indicators, Patient Reported Outcome Measures (PROMs), and Patient Reported Experience Measures (PREMs) to Improve the Quality and Continuity of Care for Psychiatric Patients
The objective of the proposed study is to take a further step in this direction by developing, implementing and monitoring a routine systematic evaluation of clinical process and outcome indicators, patient reported experience (PREMs) and patient reported outcomes (PROMs) to study the quality and continuity of care over time.
Background: Monitoring quality of care in the context of psychiatric hospitalization is
crucial. The Israeli National quality, Service and Safety Administration project has
signified a major step in this direction enhancing the measuring and monitoring the quality
of care.
Purpose: The objective of the proposed study is to take a further step in this direction by
developing, implementing and monitoring a routine systematic evaluation of clinical process
and outcome indicators, patient reported experience (PREMs) and patient reported outcomes
(PROMs) to study the quality and continuity of care over time.
Hypotheses: We hypothesize that 1) adherence to indicators will be associated with better
PREMs, PROMs and clinician ratings 2) PROMs and clinician ratings will be positively related
and 3) PREMs and PROMs will be positively related.
Method: 125 patients (ages 18-55) admitted to SHALVATA mental health center and their
clinicians will be recruited to participate in a prospective longitudinal assessment. Each
will include PREMs, PROMs clinician rated outcomes and assessment of the degree to which
clinical indicators (reflected processes of clinical guidelines) were carried out. The
assessments will take place at admission, discharge and every 3 months for up for 9 months.
The design is a repeated measures design with evaluating the interaction effect between
assessed levels of indicators ("between subject effect") and level of change in the PREMs,
PROMs clinician along the research trajectory ("within subject effect").
Importance of the study: The mental health reform, implemented cross-nationally since 2015
emphasizes client centred and continuity of care and seeks to increase the quality,
availability and accessibility of mental health services in Israel. Most of the discussion to
date has been on the later issues of access and availability and much less on quality and
continuity of care which requires standardized routine longitudinal assessment of process
indicators and patients reported experience and outcome. The proposed study represents a
pioneer effort to collect systematic data which can help evaluate the quality and impact of
services over time. Findings can be useful to guide policy about the feasibility and impact
of process indicators and their relation to PROMs and PREMs over time.
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