The past several decades of price wars in medicine have taken their
toll& mdash;and nowhere has the impact been greater than in the
field of psychiatry. Today, patients and physicians alike are
protesting& mdash;louder than ever& mdash;that quality
patient care is being sacrificed to cost-cutting goals.
"What is quality patient care"& #63; Quality measures (i.e.,
validity, reliability, feasibility, usability, and comparability)
link the care rendered to the results (i.e., outcomes) of that
care, enabling us to define, measure, publicly report, compare, and
ultimately improve care.
This remarkable volume offers a critical analysis of outcome
assessment, in psychiatry, which allows us to assess not only the
measurable domains (i.e., symptoms, functioning, quality of life,
and perception of care), but also the standards and instruments
used to judge the quality of care.
Divided into three major sections, this comprehensive textbook
is more than just an inventory or nosology of measures; rather, it
holds existing instruments to clear standards. "Section I,
Understanding Outcomes Assessment," details the many fundamental
concepts that underlie outcome measurement, including a &
ldquo;situational analysis& rdquo; of outcome assessment, the
scientific underpinnings of the field, and its important constructs
(e.g., process and outcome, efficacy and effectiveness, basis
statistics, quality improvement).
"Section II, A Critical Review of the Instruments," critiques a
wide variety of instruments that have high clinical utility, are in
the public domain or of low cost and burden, and meet many of the
quality standards of validity, reliability, feasibility, usability,
andcomparability. Organized by patient population (age, diagnoses,
and disorders), these chapters describe both general and
disorder-specific measures, with respondents that include patients,
families, and clinicians. Data generated by these instruments
therefore can be used to assess outcomes for individual patients,
populations, and programs.
"Section III, Challenges and Opportunities," discusses the
obstacles to implementing assessment programs, regulatory and
accreditation demands, confidentiality and training, and the
technology of measurement and proven solutions, including a final
chapter on future innovations using various types of brain imaging;
laboratory tests (e.g., for homovanillic acid); immunological tests
(e.g., G-protein and plasma prolactin, the
hypothalamic-pituitary-adrenal axis); and acoustic (e.g., the &
ldquo;flat affect& rdquo; of a patient& rsquo;s voice) and
other technological tests.
The three editors of this meticulously researched and written
compilation have brought together the work of 48 distinguished
contributors who, responding to today& rsquo;s mandate of
public accountability, provide clinicians and clinical leaders with
the tools they need to meaningfully incorporate quality measurement
into clinical practice.
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