Measuring quality of care can transform care, but few tools exist to measure quality from the client's perspective. The aim of this study was to create concordant clinician and client self-report quality-of-care scales in a sample of community mental health clinicians (n = 189) and clients (n = 469). The client scale had three distinct factors (Person-Centered Care, Negative Staff Interactions, and Inattentive Care), while the clinician scale had two: Person-Centered Care and Discordant Care. Both versions demonstrated adequate internal consistency and validity with measures related to satisfaction and the therapeutic relationship. These measures are promising, brief quality assessment tools.

The writing of this paper was supported by the Sandra Eskenazi Mental Health Center and the Herbert Simon Family Foundation (070241-00002B). A special thanks goes to all Eskenazi staff who led the study intervention and who assisted with recruitment, scheduling, and other study logistics.

Work stress and professional burnout are recognized as concerns for public library employees, yet little research has been conducted. The purpose of the current study was to better understand burnout and the contributing factors in a state-wide sample of public library employees in Indiana. Using a web-based survey, 171 employees of public libraries reported their level of burnout (emotional exhaustion, cynicism, and professional efficacy; Maslach Burnout InventoryGeneral Survey) and potential predictors, including levels of autonomy, co-worker support, work pressure, technology attitudes, and recovery experiences. A subset of 70 completed the burnout measures twice, allowing for predictions of change over time. Most predictors were correlated with burnout cross-sectionally, except for technology attitudes. Emotional exhaustion was positively associated with work pressure, and negatively associated with autonomy, role clarity, coworker support, and recovery experiences of relaxation, mastery, and control. Similar patterns were found for cynicism and reduced efficacy. However, over a period of approximately six months, only role clarity predicted decreased burnout (emotional exhaustion) above prior levels of burnout.

DISCLAIMER: The statements in this publication are solely the responsibility of the authors and do not necessarily represent the views of the Patient-Centered Outcomes Research Institute (PCORI), its Board of Governors or Methodology Committee. CONFLICT OF INTEREST: The authors declare that they have no conflicts of interest. ETHICAL APPROVAL: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. INFORMED CONSENT: Informed consent was obtained from all individual participants included in the study.

Objective: The current article describes efforts to develop and test a measure of recovery-oriented inpatient care. Method: The Recovery-oriented Acute INpatient (RAIN) scale was based on prior literature and current Veterans Health Administration (VHA) policy and resources and further revised based on data collection from 34 VHA acute inpatient units. Results: A final scale of 23, behaviorally anchored items demonstrated a fourfactor structure including the following factors: inpatient treatment planning, outpatient treatment planning, group programming, and milieu. While several items require additional revision to address psychometric concerns, the scale demonstrated adequate model fit and was consistent with prior literature on recoveryoriented inpatient care. Conclusions and Implementations for Practice: The RAIN scale represents an important tool for future implementation and empirical study of recovery-oriented inpatient care. Impact and ImplicationsThis study focused on developing a scale to measure recovery-oriented inpatient mental health care. The study found a 23-item scale matched prior literature and included four general areas of recovery-oriented inpatient care: inpatient treatment planning, outpatient treatment planning, group programming, and milieu. This scale can be used to improve the recovery orientation of inpatient programming.