Optimizing clinical care through implementation of outcome monitoring systems

Abstract

Traditional 'one-off' research studies are no longer considered sufficient to demonstrate the effectiveness of treatment programs. State-mandated clinical and administrative databases and treatment outcome monitoring systems (OMSs) are increasingly being recognized as necessary to provide current, representative, ongoing information that can immediately be fed back to service providers to improve the quality of services. OMSs can also provide reliable, aggregated and comparable data to inform the planning and development of treatment delivery services. Increasingly, routinely collected clinical data is being used to investigate alcohol and other drug (AOD) service delivery, client characteristics and to report on treatment outcomes. Debate persists as to whether OMSs should be mandated for use across jurisdictions or be locally-based and voluntarily undertaken, serving the needs of a smaller network of services. This article outlines the features, benefits and challenges associated with the design and implementation of OMSs in the AOD treatment sector. Particular reference is made to promoting and evaluating the impact of OMSs in Australia in an effort to enhance clinical service delivery and promote best practice in the AOD treatment sector.

Validation and implementation of the Australian Treatment Outcomes Profile in specialist drug and alcohol settings

“…The clinical utility of the treatment outcome instrument was viewed as critical to successful uptake [3,8].…”

“…Barriers to the successful implementation of COM systems include the length, time and training requirements of instruments used; poor integration with clinical information systems and inattention to data entry requirements; poor feedback for clients, clinicians and program administrators; and clinician and client perceptions of outcome monitoring as a bureaucratic process, with subsequent poor adherence by staff [3,8,9,14].…”

“…number of treatment episodes), possibly with some 'baseline' client descriptors and a broad categorisation of conditions of treatment cessation [1][2][3]. This gives no indication of how effective a treatment service is in improving its clients' health.…”

“…Clinical outcome monitoring (COM), where a client's status on a predetermined indicator (or set of indicators) is assessed at routine points over time, gives a measure of client response to an intervention or group of interventions [2,[4][5][6]. The potential benefits of routine COM in D&A treatment include regular feedback to clients and clinicians; informing treatment care planning for individual clients; and assisting in quality improvement, evaluation, research, planning and performance monitoring at a service level [3,[6][7][8][9].…”

Routine outcome measurement in specialist non‐government alcohol and other drug treatment services: Establishing effectiveness indicators for the NADAbase

“…Routine outcome measurement (ROM) is increasingly promoted for use within mental health [1] and alcohol and other drug (AOD) treatment settings [2][3][4]. Measures used for ROM are considered an important component of individual client care, with evidence that the use of ROM improves treatment adherence and enhances client outcomes [4][5][6].…”