Many organizations and programs accredited under TJC’s Behavioral Healthcare standards are striving to implement the new outcomes measurement requirements effective January 2018. (See our October 2017 newsletter.)
Several readers have asked what instruments folks are using. So, we thought it would be helpful to share the experience of our long-term client Four Winds Hospital in Saratoga Springs, New York. This freestanding psychiatric hospital utilizes the Behavior and Symptom Identification Scale (BASIS-32) for both its adult inpatient units and its adult PHP/IOP programs. They had been using the BASIS-32 for many years for inpatients and then later expanded the tool to the PHP/IOP programs.
The BASIS-32 is a 32 item outcomes measurement tool that is well known in the industry. It cuts across diagnoses and measures the change in self-reported symptoms over the course of treatment. The tool measures the degree of difficulty the patient is experiencing in five domains: Relation to Self and Others; Depression and Anxiety; Daily Living and Role Functioning; Impulsive and Addictive Behavior; and Psychosis.
I recently spoke with CEO Dr. Samuel Bastien and Director of Quality Management Erin Dorflinger, LCSW-R, at Four Winds Hospital about how they are using the tool now in light of the new TJC requirements. Here’s their feedback:
How did you decide to use the BASIS-32 to meet the new requirements for outcomes measurement?
“That was a natural progression for us. We had used the BASIS-32 on Inpatient for more than 20 years and in our PHP and IOP programs for several years. The new TJC Behavioral Health requirements (which apply to our PHP and IOP) gave us an opportunity to expand our outcomes measurement process in those programs.”
How are you using the data you collect?
“We see it as a means of collaborating with patients in their recovery. It’s a way to empower patients to be partners in their treatment. Also, the outcomes measurement data enables us to demonstrate to our stakeholders that our services improve the quality of life for those in our care.”
What about the new requirement that the data also be used to evaluate the progress of individual patients? How are you tackling that?
“That’s a more recent development and it’s an exciting one! We are able to feed the BASIS-32 data back to our PHP/IOP clinicians on a patient-specific basis. They get individual patient profiles that show the changes in scores from the time of admission to their mid-point in treatment which is typically about 2 weeks after admission. We put the patient’s score in the initial treatment plan; then the new score 2 weeks later, and again at the end of the treatment episode. The technology really helps with this. The online Dynamic Forms survey tool provides a Basis32 Patient Score for every completed survey in real time.
“We encourage the clinicians to share the data with patients so they can see how they’re progressing toward their treatment goals. Then, adjustments can be made to the treatment plan based on the patient’s self-report of their progress. That’s the exciting part – getting the patients involved in looking at their own scores and what it means for their treatment and their progress.”
What are the next steps for your outcomes measurement program?
“Our focus is on continuing to work with our therapists to have them share the results with patients and incorporate the results into the treatment plan. We also want to have them capture in their progress notes how they are using the tool and what they are talking with patients about when they share the results with them. We work hard on helping the therapists understand the spirit of why we’re measuring the patient’s progress; not just because it’s a requirement of the standards. We also plan to get more feedback from patients about their experience with using the tool as part of their treatment.”
Many thanks to our Four Winds colleagues for sharing their experience with us! We’re interested in hearing from other readers about how they’re tackling the new outcomes measurement requirement in their organizations and would be happy to share that info through our newsletter.